Development and Validation of a Classification System to Identify High-Grade Dysplasia and Esophageal Adenocarcinoma in Barrett’s Esophagus Using Narrow-Band Imaging

Sharma, Prateek; Bergman, Jacques; Goda, Kenichi; Kato, Mototsugu; Messmann, Helmut; Alsop, Benjamin R.; Gupta, Neil; Vennalaganti, Prashanth; Hall, Matt; Konda, Vani J.; Koons, Ann; Penner, O.L.G.A.; Goldblum, John R.; Waxman, Irving

doi:10.1053/j.gastro.2015.11.037

Cited by 219 publications

(181 citation statements)

References 35 publications

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“…Irregular mucosal patterns were marked by various forms, heterogeneous sizes, irregular arrangement, high density, and indistinct or invisible white zone [11–13]. …”

Section: The Jes-be Classification Systemmentioning

confidence: 99%

Newly developed magnifying endoscopic classification of the Japan Esophageal Society to identify superficial Barrett’s esophagus-related neoplasms

et al. 2018

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Aim and methodsThe Japan Esophageal Society created a working committee group consisting of 11 expert endoscopists and 2 pathologists with expertise in Barrett’s esophagus (BE) and esophageal adenocarcinoma. The group developed a consensus-based classification for the diagnosis of superficial BE-related neoplasms using magnifying endoscopy.ResultsThe classification has three characteristics: simplified, an easily understood classification by incorporating the diagnostic criteria for the early gastric cancer, including the white zone and demarcation line, and the presence of a modified flat pattern corresponding to non-dysplastic histology by adding novel diagnostic criteria. Magnifying endoscopic findings are composed of mucosal and vascular patterns, and are initially classified as “visible” or “invisible.” Morphologic features were evaluated for “visible” patterns, and were subsequently rated as “regular” or “irregular,” and the histology, non-dysplastic or dysplastic, was predicted.ConclusionWe introduce the process and outline of the magnifying endoscopic classification.

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“…Irregular mucosal patterns were marked by various forms, heterogeneous sizes, irregular arrangement, high density, and indistinct or invisible white zone [11–13]. …”

Section: The Jes-be Classification Systemmentioning

confidence: 99%

Newly developed magnifying endoscopic classification of the Japan Esophageal Society to identify superficial Barrett’s esophagus-related neoplasms

et al. 2018

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“…2). Validation studies of this classification using ME-NBI showed that the BING classification can predict the presence or absence of dysplasia with a high level of accuracy (> 90%) and very high interobserver agreement [1, 25, 26]. However, without magnification this classification seems less useful, based on a recent study evaluating HD-NBI without magnification in the diagnosis of dysplasia [27].…”

Section: Esophagusmentioning

confidence: 99%

Narrow-Band Imaging: Clinical Application in Gastrointestinal Endoscopy

Barbeiro

Libânio

Castro

et al. 2018

GE Port J Gastroenterol

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Narrow-band imaging is an advanced imaging system that applies optic digital methods to enhance endoscopic images and improves visualization of the mucosal surface architecture and microvascular pattern. Narrow-band imaging use has been suggested to be an important adjunctive tool to white-light endoscopy to improve the detection of lesions in the digestive tract. Importantly, it also allows the distinction between benign and malignant lesions, targeting biopsies, prediction of the risk of invasive cancer, delimitation of resection margins, and identification of residual neoplasia in a scar. Thus, in expert hands it is a useful tool that enables the physician to decide on the best treatment (endoscopic or surgical) and management. Current evidence suggests that it should be used routinely for patients at increased risk for digestive neoplastic lesions and could become the standard of care in the near future, at least in referral centers. However, adequate training programs to promote the implementation of narrow-band imaging in daily clinical practice are needed. In this review, we summarize the current scientific evidence on the clinical usefulness of narrow-band imaging in the diagnosis and characterization of digestive tract lesions/cancers and describe the available classification systems.

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“…Endoscopic ultrasonography (EUS) was used when the invasion depth was difficult to diagnose by white light endoscopy. Lateral tumor margin was determined as the demarcation line using narrow band imaging-magnifying endoscopy (NBI-ME) in all cases before ESD, observing mucosal structure and vascular pattern irregularity [15,16]. In addition, negative biopsies were taken from outside the estimated demarcation line to pathologically confirm the margin.…”

Section: Endoscopic Diagnosismentioning

confidence: 99%

Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett’s Esophagus versus Short-Segment Barrett’s Esophagus

et al. 2018

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Background: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett’s esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett’s esophagus (LSBE) cancer is unknown. Aim: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. Methods: A total of 86 patients with 91 superficial Barrett’s esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE. Procedure outcomes and prognosis were compared. Results: There was no significant difference in age and tumor diameter among patients. The only complication observed was stricture, but it was not significant (2 vs. 9%). No significant difference was observed in the negative horizontal margin rates (94.1 vs. 95.7%), R0 resection rates (83.8 vs. 82.6%), curative resection rates (72.1 vs. 73.9%), and noncurative factors. Both LSBE and SSBE cancer showed favorable 3-year overall survival rates (95.0 vs. 94.4%) in the median observation period of 28.5 months. Conclusions: ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE.

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Development and Validation of a Classification System to Identify High-Grade Dysplasia and Esophageal Adenocarcinoma in Barrett’s Esophagus Using Narrow-Band Imaging

Cited by 219 publications

References 35 publications

Newly developed magnifying endoscopic classification of the Japan Esophageal Society to identify superficial Barrett’s esophagus-related neoplasms

Newly developed magnifying endoscopic classification of the Japan Esophageal Society to identify superficial Barrett’s esophagus-related neoplasms

Narrow-Band Imaging: Clinical Application in Gastrointestinal Endoscopy

Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett’s Esophagus versus Short-Segment Barrett’s Esophagus

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