Advances in the diagnosis and surveillance of Barrett's esophagus (with videos)

ASGE Technology Committee; Arvind J Trindade; Udayakumar Navaneethan; Harry R Aslanian; Manoop S Bhutani; Kumar Krishnan; David R Lichtenstein; Joshua Melson; Rahul Pannala; Mansour A Parsi; Allison R Schulman; Amrita Sethi; Guru Trikudanathan; Rabindra R Watson; John T Maple

doi:10.1016/j.gie.2019.05.004

Advances in the diagnosis and surveillance of Barrett's esophagus (with videos)

Gastrointest Endosc. 2019 Sep;90(3):325-334. doi: 10.1016/j.gie.2019.05.004. Epub 2019 May 18.

Authors

Affiliations

¹ Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York.
² Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida.
³ Section of Digestive Diseases, Department of Internal Medicine, Yale University, New Haven, Connecticut.
⁴ Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, The University of Texas, Houston, Texas.
⁵ Division of Gastroenterology, Department of Internal Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts.
⁶ Division of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
⁷ Division of Digestive Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
⁸ Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona.
⁹ Department of Gastroenterology and Hepatology, Tulane University, New Orleans, Louisiana.
¹⁰ Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan.
¹¹ Division of Digestive and Liver Diseases, Columbia University Medical Center-New York-Presbyterian, New York, New York.
¹² Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota.
¹³ Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California.
¹⁴ Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

PMID: 31113535
DOI: 10.1016/j.gie.2019.05.004

Abstract

Background and aims: Most patients diagnosed with esophageal adenocarcinoma do not carry a known diagnosis of Barrett's esophagus (BE), suggesting that an improved approach to screening may potentially be of benefit. The use of dysplasia as a biomarker and random biopsy protocols for its detection has limitations. In addition, detecting and appropriately classifying dysplasia in patients with known BE can be difficult.

Methods: This document reviews several technologies with a recently established or potential role in the diagnosis and/or surveillance of BE as well as risk stratification for progression to esophageal adenocarcinoma.

Results: Two technologies were reviewed for imaging or tissue sampling: (1) wide-area transepithelial sampling and (2) volumetric laser endomicroscopy. Four technologies were reviewed for molecular and biomarker technologies for diagnosis and risk stratification: (1) Cytosponge, (2) mutational load, (3) fluorescence in situ hybridization, and (4) immunohistochemistry.

Conclusion: Several technologies discussed in this document may improve dysplasia detection in BE in a wide-field manner. Moreover, the addition of different biomarkers may aid in enhanced risk stratification to optimize approaches to surveillance or treatment for patients with BE.

Publication types

Review
Video-Audio Media

MeSH terms

Adenocarcinoma / epidemiology*
Barrett Esophagus / diagnosis*
Barrett Esophagus / metabolism
Barrett Esophagus / pathology
Biopsy / methods
Disease Progression
Esophageal Neoplasms / epidemiology*
Esophagoscopy / methods
Humans
Imaging, Three-Dimensional
Immunohistochemistry
In Situ Hybridization, Fluorescence
Microscopy, Confocal / methods
Risk Assessment
Watchful Waiting

Supplementary concepts

Adenocarcinoma Of Esophagus