Are ulcers a marker for invasive carcinoma in barrett's esophagus? data from a diagnostic variability study with clinical follow-up
dc.contributor.author | Montgomery, Elizabeth | en_US |
dc.contributor.author | Bronner, Mary P. | en_US |
dc.contributor.author | Greenson, Joel K. | en_US |
dc.contributor.author | Haber, Marian M. | en_US |
dc.contributor.author | Hart, John | en_US |
dc.contributor.author | Lamps, Laura W. | en_US |
dc.contributor.author | Lauwers, Gregory Y. | en_US |
dc.contributor.author | Lazenby, Audrey J. | en_US |
dc.contributor.author | Lewin, David N. | en_US |
dc.contributor.author | Robert, Marie E. | en_US |
dc.contributor.author | Washington, Kay | en_US |
dc.contributor.author | Goldblum, John R. | en_US |
dc.date.accessioned | 2010-06-01T22:09:58Z | |
dc.date.available | 2010-06-01T22:09:58Z | |
dc.date.issued | 2002-01 | en_US |
dc.identifier.citation | Montgomery, Elizabeth; Bronner, Mary P . ; Greenson, Joel K . ; Haber, Marian M . ; Hart, John; Lamps, Laura W . ; Lauwers, Gregory Y . ; Lazenby, Audrey J . ; Lewin, David N . ; Robert, Marie E . ; Washington, Kay; Goldblum, John R . (2002). "Are ulcers a marker for invasive carcinoma in barrett's esophagus? data from a diagnostic variability study with clinical follow-up." The American Journal of Gastroenterology 97(1): 27-31. <http://hdl.handle.net/2027.42/75186> | en_US |
dc.identifier.issn | 0002-9270 | en_US |
dc.identifier.issn | 1572-0241 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/75186 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=11808966&dopt=citation | en_US |
dc.description.abstract | We correlated follow-up information from 138 patients with Barrett's esophagus and varying degrees of dysplasia with the presence of ulcers. Methods A group of pathologist participants were asked to contribute patients’ initial biopsy slides showing Barrett's esophagus (BE) without dysplasia and with epithelial changes indefinite for dysplasia, low grade dysplasia (LGD), high grade dysplasia (HGD), and adenocarcinoma. From the initial 250 cases used for a diagnostic reproducibility study, follow-up information was available for 138 patients. Results There were 44 cases submitted as BE, 22 as BE with epithelial changes indefinite for dysplasia, 26 as BE with LGD, 33 as BE with HGD, and 13 as BE with adenocarcinoma. Ulcers were present in 35/138 cases (25%), including 3/44 cases of BE without dysplasia (7%), 2/22 cases of BE with epithelial changes indefinite for dysplasia (9%), 0/26 cases of BE with LGD (0%), 10/33 cases of BE with HGD (30%), and 7/13 cases of BE with adenocarcinoma (54%). On follow-up, there were no invasive carcinomas detected among the BE without dysplasia group (median follow-up = 38.5 months). Adenocarcinomas were detected in 4/22 cases (18%) submitted as BE with epithelial changes indefinite for dysplasia at 19, 55, 60, and 62 months and in 4/26 cases (15%) of BE with LGD at 9, 9, 11, and 60 months. None of these carcinomas occurred in cases in which an ulcer was present in the initial biopsy specimen. Among the 33 HGD cases, 20 (60%) were found to have adenocarcinoma on subsequent resection specimens. The presence of an ulcer with HGD increased the likelihood of finding carcinoma in the resection specimen, as 8/10 biopsies (80%) of HGD patients with ulcers had carcinoma, compared to 12/23 biopsies (52%) of HGD patients without ulcers. All of the cases interpreted as adenocarcinomas on biopsy were found either to have invasive carcinoma on esophageal resection or to have metastases that were demonstrated in unresectable patients. Conclusion If an ulcer accompanies HGD in a biopsy specimen from a patient with BE, it is likely that invasive carcinoma is also present at that time. | en_US |
dc.format.extent | 357431 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Publishing Ltd | en_US |
dc.rights | 2002 by Am. Coll. of Gastroenterology | en_US |
dc.title | Are ulcers a marker for invasive carcinoma in barrett's esophagus? data from a diagnostic variability study with clinical follow-up | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, The Johns Hopkins University, Baltimore, Maryland, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, University of Washington, Seattle, Washington, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, MCP Hahnemann University, Philadelphia, Pennsylvania, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, University of Chicago, Chicago, Illinois, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, University of Arkansas, Fayetteville, Arkansas, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, University of Alabama, Birmingham, Alabama, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, Yale University, New Haven, Connecticut, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, Vanderbilt University, Nashville, Tennessee, USA | en_US |
dc.contributor.affiliationother | Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA | en_US |
dc.identifier.pmid | 11808966 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/75186/1/j.1572-0241.2002.05420.x.pdf | |
dc.identifier.doi | 10.1111/j.1572-0241.2002.05420.x | en_US |
dc.identifier.source | The American Journal of Gastroenterology | en_US |
dc.identifier.citedreference | Barrett N.. Chronic peptic ulcer of the oesophagus and “oesophagitis ”. Br J Surg 1950; 38: 175 – 182. | en_US |
dc.identifier.citedreference | Barrett N.. The lower esophagus lined by columnar epithelium. Surgery 1957; 41: 881 – 894. | en_US |
dc.identifier.citedreference | Bramble M.G., Suvakovic Z., Hungin A.P.. Detection of upper gastrointestinal cancer in patients taking antisecretory therapy prior to gastroscopy. Gut 2000; 46: 464 – 467. | en_US |
dc.identifier.citedreference | Blot W.J., Devesa S.S., Kneller R.W., Fraumeni J.F., Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991; 265: 1287 – 1289. | en_US |
dc.identifier.citedreference | Lagergren J., Bergstrom R., Lindgren A., Nyren O.. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 1999; 340: 825 – 831. | en_US |
dc.identifier.citedreference | Montgomery E., Goldblum J.R., Greenson J.K., et al. Dysplasia as a predictive marker for invasive carcinoma in Barrett esophagus: A follow-up study based on 138 cases from a diagnostic variability study. Hum Pathol 2001; 32: 379 – 388. | en_US |
dc.identifier.citedreference | Montgomery E., Bronner M.P., Goldblum J.R., et al. Reproducibility of the diagnosis of dysplasia in Barrett esophagus: A reaffirmation. Hum Pathol 2001; 32: 368 – 378. | en_US |
dc.identifier.citedreference | Levine D.S., Haggitt R.C., Blount P.L., et al. An endoscopic biopsy protocol can differentiate high-grade dysplasia from early adenocarcinoma in Barrett's esophagus. Gastroenterology 1993; 105: 40 – 50. | en_US |
dc.identifier.citedreference | Levine D.S., Blount P.L., Rudolph R.E., Reid B.J.. Safety of a systematic endoscopic biopsy protocol in patients with Barrett's esophagus. Am J Gastroenterol 2000; 95: 1152 – 1157. | en_US |
dc.identifier.citedreference | Reid B.J., Haggitt R.C., Rubin C.E., et al. Observer variation in the diagnosis of dysplasia in Barrett's esophagus. Hum Pathol 1988; 19: 166 – 178. | en_US |
dc.identifier.citedreference | Reid B.J., Levine D.S., Longton G., et al. Predictors of progression to cancer in Barrett's esophagus: Baseline histology and flow cytometry identify low- and high-risk patient subsets. Am J Gastroenterol 2000; 95: 1669 – 1676. | en_US |
dc.identifier.citedreference | Heitmiller R.F., Redmond M., Hamilton S.R.. Barrett's esophagus with high-grade dysplasia. An indication for prophylactic esophagectomy. Ann Surg 1996; 224: 66 – 71. | en_US |
dc.identifier.citedreference | Ireland A.P., Clark G.W., DeMeester T.R.. Barrett's esophagus. The significance of p53 in clinical practice. Ann Surg 1997; 225: 17 – 30. | en_US |
dc.identifier.citedreference | Schnell T.G., Sontag S.J., Chejfec G., et al. Long-term nonsurgical management of barrett's esophagus with high-grade dysplasia. Gastroenterology 2001; 120: 1607 – 1619. | en_US |
dc.identifier.citedreference | Pellegrini C.A., Pohl D.. High-grade dysplasia in Barrett's esophagus: Surveillance or operation?. J Gastrointest Surg 2000; 4: 131 – 134. | en_US |
dc.identifier.citedreference | Burke A.P., Sobin L.H., Shekitka K.M., Helwig E.B.. Dysplasia of the stomach and Barrett esophagus: A follow-up study. Mod Pathol 1991; 4: 336 – 341. | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.