Incremental yield of dysplasia detection in Barrett’s esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol - 21/06/18
Abstract |
Background and Aims |
Volumetric laser endomicroscopy (VLE) is a new wide-field advanced imaging technology for Barrett’s esophagus (BE). No data exist on incremental yield of dysplasia detection. Our aim is to report the incremental yield of dysplasia detection in BE using VLE.
Methods |
This is a retrospective study from a prospectively maintained database from 2011 to 2017 comparing the dysplasia yield of 4 different surveillance strategies in an academic BE tertiary care referral center. The groups were (1) random biopsies (RB), (2) Seattle protocol random biopsies (SP), (3) VLE without laser marking (VLE), and (4) VLE with laser marking (VLEL).
Results |
A total of 448 consecutive patients (79 RB, 95 SP, 168 VLE, and 106 VLEL) met the inclusion criteria. After adjusting for visible lesions, the total dysplasia yield was 5.7%, 19.6%, 24.8%, and 33.7%, respectively. When compared with just the SP group, the VLEL group had statistically higher rates of overall dysplasia yield (19.6% vs 33.7%, P = .03; odds ratio, 2.1, P = .03). Both the VLEL and VLE groups had statistically significant differences in neoplasia (high-grade dysplasia and intramucosal cancer) detection compared with the SP group (14% vs 1%, P = .001 and 11% vs 1%, P = .003).
Conclusion |
A surveillance strategy involving VLEL led to a statistically significant higher yield of dysplasia and neoplasia detection compared with a standard random biopsy protocol. These results support the use of VLEL for surveillance in BE in academic centers.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Abbreviations : BE, CI, NBI, OCT, RB, SP, VLE, VLEL
Plan
| If you would like to chat with an author of this article, you may contact Dr Trindade at arvind.trindade@gmail.com. |
|
| DISCLOSURE: Dr Sejpal has served on an Advisory Board for Ninepoint. All other authors disclosed no financial relationships relevant to this publication. |
Vol 88 - N° 1
P. 35-42 - juillet 2018 Retour au numéro
Article précédent
- Nutrition before chemoradiotherapy or surgery: Temporary esophageal stents or tube feeding? Is the evidence hard to swallow?
- Jose Guillermo de la Mora Levy, Maria del C. Manzano-Robleda
- Is more always better in Barrett’s esophagus?
- Cadman L. Leggett
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?