Comparison of Cancer-Associated Genetic Abnormalities in Columnar-Lined Esophagus Tissues With and Without Goblet Cells

Bandla, Santhoshi; Peters, Jeffrey H.; Ruff, David; Chen, Shiaw Min; Li, Chieh Yuan; Song, Kunchang; Thoms, Kimberly; Litle, Virginia R.; Watson, Thomas J.; Chapurin, Nikita; Lada, Michal J.; Pennathur, Arjun; Luketich, James D.; Peterson, Derick R.; Dulak, Austin; Lin, Lin; Bass, Adam J.; Beer, David G.; Godfrey, Tony E.; Zhou, Zhongren

doi:10.1097/sla.0000000000000424

Cited by 68 publications

(28 citation statements)

References 36 publications

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“…However, not all studies have corroborated this fi nding ( 12 ). Although DNA content abnormalities appear to be comparable in both metaplastic epithelium without goblet cells compared with metaplastic epithelium with goblet cells, other studies suggest that cancer most commonly occurs in columnar metaplasia with goblet cells compared with columnar metaplasia without goblet cells ( 11,13,14 ). Even if the rate of EAC is markedly higher in CLE containing IM, another complicating factor is sampling error leading to misclassifi cation of IM-containing CLE as non-IM CLE.…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,335

1,412

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Recent population studies suggest that gastroesophageal refl ux disease (GERD) is increasing in prevalence, both in the United States and worldwide ( 1,2 ). Th e diagnosis of GERD is associated with a 10-15% risk of Barrett's esophagus (BE), a change of the normal squamous epithelium of the distal esophagus to a columnar-lined intestinal metaplasia (IM). Risk factors associated with the development of BE include long-standing GERD, male gender, central obesity ( 3 ), and age over 50 years ( 4,5 ). Th e goal of a screening and surveillance program for BE is to identify individuals at risk for progression to esophageal adenocarcinoma (EAC), a malignancy that has been increasing in incidence since the 1970s ( 6,7 ).Th e purpose of this guideline is to review the defi nition and epidemiology of BE, available screening modalities for BE detection, rationale and methods for surveillance, and available treatment modalities including medical, endoscopic, and surgical techniques. In order to evaluate the level of evidence and strength of recommendations, we used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system ( 8 ). Th e level of evidence ranged from "high" (implying that further research was unlikely to change the authors' confi dence in the estimate of the eff ect) to "moderate" (further research would be likely to have an impact on the confi dence in the estimate of eff ect) to "low" (further research would be expected to have an important impact on the confi dence in the estimate of the eff ect and would be likely to change the estimate) or "very low" (any estimate of eff ect is very uncertain). Th e strength of a recommendation was graded as "strong" when the desirable eff ects of an intervention clearly outweighed the undesirable eff ects and as "conditional" when there was uncertainty about the tradeoff s. We used meta-analyses or systematic reviews when available, followed by clinical trials and cohort and case-control studies. In order to determine the level Barrett's esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with refl ux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3-5 years. Neither routine use of biomarker panels nor advanced endoscopic imaging techniques (beyond high-defi nition endoscopy) is recommended at this time. Endoscopic ablative therapy is recommended for patients with BE and high-grade dysplasia, as well as T1a esophageal adenocarcinoma. Based on recent level 1 evidence, endoscopic ablative therapy is ...

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Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,335

1,412

View full text Add to dashboard Cite

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“…In a recent study of 45 BE patients, Bandla et al performed targeted sequencing of all exons from 20 adenocarcinoma-associated genes and found that intestinal metaplasia had a much higher frequency of cancer-associated mutations than non-goblet metaplastic epithelium [69]. In a study of 8522 patients with BE, Bhat S, et al reported that the cancer risk was 0.07% in patients without goblet cells, compared to 0.38% in those with goblet cells at index biopsy (p<0.001) [70].…”

Section: Should Goblet Cells Be Required For the Diagnosis Of Barrettmentioning

confidence: 97%

Barrett's oesophagus diagnostic criteria: endoscopy and histology

Naini

Chak

Ali

et al. 2015

Best Practice & Research Clinical Gastroenterology

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“…29 However, some studies suggest that metaplastic columnar epithelium without goblet cells may show similar, or even equal, molecular abnormalities to those that occur in patients with goblet cells. 18, 30–32 For instances, in a study by Liu et al, 68 patients with BE were analyzed for DNA content by image cytometry and high fidelity histograms.…”

Section: Definition and Diagnostic Criteria Of Barrett’s Esophagusmentioning

confidence: 99%

Barrett’s Esophagus

Naini¹,

Souza²,

Odze

2016

American Journal of Surgical Pathology

131

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This review provides a summary of our current understanding of, and the controversies regarding, the diagnosis, pathogenesis, histopathology, and molecular biology of Barrett's esophagus (BE) and associated neoplasia. Barrett's esophagus is defined as columnar metaplasia of the esophagus. There is worldwide controversy regarding the diagnostic criteria of BE, mainly with regard to the requirement to histologically identify goblet cells in biopsies. Patients with BE are at increased risk for adenocarcinoma which develops via a metaplasia-dysplasia-carcinoma sequence. Surveillance of patients with BE relies heavily on the presence and grade of dysplasia. However, there are significant pathologic limitations and diagnostic variability in evaluating dysplasia, particularly with regard to the more recently recognized unconventional variants. Identification of non-morphology based biomarkers may help risk stratification of BE patients and this is a subject of ongoing research. Due to recent achievements in endoscopic therapy, there has been a major shift in the treatment of BE patients with dysplasia or intramucosal cancer, away from esophagectomy and towards endoscopic mucosal resection and ablation. The pathologic issues related to treatment and its complications are also discussed in this review article.

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Comparison of Cancer-Associated Genetic Abnormalities in Columnar-Lined Esophagus Tissues With and Without Goblet Cells

Cited by 68 publications

References 36 publications

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Barrett's oesophagus diagnostic criteria: endoscopy and histology

Barrett’s Esophagus

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