#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Use of NBI in diagnostics and monitoring of patients with Barrett's oesophagus


Authors: J. Gregar 1;  V. Procházka 1;  P. Lužná 2;  J. Ehrmann jr. 2,3
Authors‘ workplace: I. interní klinika gastro-enterologická a hepatologická, FN Olomouc , Ústav histologie a embryologie, LF UP Olomouc , Ústav klinické a molekulární patologie, LF UP Olomouc 1
Published in: Gastroent Hepatol 2012; 66(3): 165-169
Category: Digestive Endoscopy: Original Article

Overview

The aim of the study was to evaluate the accuracy of NBI (Narrow Band Imaging) endoscopy. We wanted to ascertain the ability of NBI to predict dysplastic changes in Barrett’s oesophagus (BE) patients and to predict low-grade dysplasia ­(low-grade intraepithelial neoplasia, LG) and high-grade dysplasia (high-grade intraepithelial neoplasia, HG).

Material and methods:
Our study was performed on a group of 82 patients with diagnosis of Barrett’s oesophagus. In these patients we compared the results of endoscopic investigation in NBI mode with the histopathological assessment. All samples were examined by two experienced pathologists.

Results:
We suspected 27 patients of dysplastic changes based on NBI endoscopy – 24 (88.9%) of them tested positive for the histopathological assessment of dysplasia, while 3 (11.1%) of them tested negative for the histopathological assessment of dysplasia. On the other hand, we saw a high rate of false negative results of NBI endoscopy. Histopathological assessment of dysplasia was found in 40 patients (34 patients LG, 6 patients HG) out of 82. Out of 34 patients with LG dysplasia (histopatho­logical assessment) there were only 18 (52.9%) patients with positive NBI endoscopy, while 16 patients (47.1%) were negative. All pa­tients with HG dysplasia (histopathological assessment) were positive in NBI endoscopy.

Conclusion:
The positive prediction of NBI endo­scopy for dysplastic changes in BE was 88.9%. Thus, it seems NBI is a useful and beneficial examination method for patients with Barrett’s oesophagus.

Key words:
Barrett’s oesophagus – NBI (Narrow Band Imaging) – histopathological assessment – low-grade dysplasia (low-grade intraepithelial neoplasia) – high-grade dysplasia (high-grade intraepithelial neoplasia)


Sources

1. Barrett NR. Chronic peptic ulcer of the oesophagus lined by columnar epithelium. Surgery 1957; 41(6): 881–894.

2. Devesa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998; 83(10): 2049–2053.

3. Guidelines České gastroenterologické společnosti. http://www.cgs-cls.cz/zc/img//Cgs-cls/refluxni_choroba_jicnu.doc.

4. Lukáš K. Barrettův jícen z pohledu gastro­enterologa. Novinky z gastroenterologie 2003; 1: 3–6.

5. Shaheen NJ, Crosby MA, Bozynski EM et al. Is there publication bias in the reporting of cancer risk of Barrett's esophagus? Gastroenterology 2000; 119(2): 333–338.

6. Jankowski J, Provenzale D, Moayyedi P. Oesophageal adenocarcinoma arising from Barrett´s metaplasma has regional varia­tions in the West. Gastroenterology 2002; 122(2): 588–590.

7. Pera M, Manterola C, Vidal O et al. Epidemiology of esophageal adenocarcinoma. J Surg Oncol 2005; 92(3): 151–159.

8. Singh R, Anagnostopoulos GK, Fortun PJ. Narrow-band imaging with magnification in Barrett's esophagus: validation of a simplified grading system of mucosal morphology patterns against histology. Endoscopy 2008; 40(6): 457–463.

9. Kment M. Barrettův jícen – ideální studijní model kancerogeneze? Čes a Slov Gastroent a Hepatol 2007; 61(1): 47–54.

10. Sharma P, Bansal A, Mathur S. The utility of a novel narrow band imaging endo­scopy system in patients with Barrett esophagus. Gastrointest Endosc 2006; 64(2): 167–175.

11. Al Tashi M et al. Barrettův jícen. Výskyt a komplikace onemocnění v období ­1994–2003. Čes a Slov Gastroent a Hepa­tol 2005; 59(2): 62–65.

12. Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med 2003; 349: 2241–2252.

13. Martínek J et al. Low incidence of adeno­carcinoma and high-grade intraepithelial neoplasia in patients with Barrett´s esophagus: a prospective cohort study. Endo­scopy 2008; 40(9): 711–716.

14. Stefanová et al. Přínos autofluorescence v diagnostice lehké intraepiteliální neoplazie u pacientů s Barrettovým jícnem. Gastroent a Hepatol 2011; 65(5): 249–254.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Article was published in

Gastroenterology and Hepatology

Issue 3

2012 Issue 3

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#