Patients With Barrett's Esophagus and Confirmed Persistent Low-Grade Dysplasia Are at Increased Risk for Progression to Neoplasia
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View abstract on PubMed
Summary
This summary is machine-generated.The number of pathologists agreeing on low-grade dysplasia (LGD) and its persistence over time significantly increase the risk of progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in Barrett's esophagus patients. These factors aid in risk stratification for targeted therapy.
Area Of Science
- Gastroenterology
- Oncology
- Pathology
Background
- Barrett's esophagus carries a risk of progression to esophageal adenocarcinoma (EAC).
- Diagnosis of low-grade dysplasia (LGD) in Barrett's esophagus is subjective, leading to variable outcomes.
- Accurate risk stratification for LGD progression is crucial for patient management.
Purpose Of The Study
- To identify factors associated with progression from LGD to high-grade dysplasia (HGD) or EAC.
- To analyze data from a multicenter study on endoscopic therapy for LGD.
- To improve risk stratification for patients with Barrett's esophagus and LGD.
Main Methods
- Retrospective analysis of 255 patients with LGD from a European randomized controlled trial.
- Independent review of baseline and follow-up LGD specimens by three expert pathologists.
- Logistic regression analysis to assess associations between LGD progression and factors like pathologist agreement and persistence.
Main Results
- 18% of patients progressed to HGD or EAC during a median follow-up of 42 months.
- Agreement of all three pathologists on LGD significantly increased progression risk (OR, 47.14).
- Persistent LGD, confirmed by a subsequent endoscopy, also greatly increased neoplasia risk (OR, 9.28).
Conclusions
- The number of pathologists confirming LGD and its persistence over time are key predictors of progression to HGD or EAC.
- These readily available factors can help stratify risk in patients with Barrett's esophagus and LGD.
- Risk stratification can guide the selection of patients for prophylactic ablation therapy.
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