High rate of over-staging of Barrett's neoplasia with endoscopic ultrasound: Systemic review and meta-analysis

AGA Clinical Practice Update on the Utility of Endoscopic Submucosal Dissection in T1b Esophageal Cancer: Expert Review

“…In other words, 36% of patients diagnosed as having T1b lesions on EUS were found to have low-grade dysplasia, highgrade dysplasia, or T1a tumor on histology. 11 Similar findings were also noted in ESCC. In a retrospective study of 174 patients with ESCC, NBI was shown to have higher accuracy than EUS in differentiating tumors limited to superficial mucosa compared with tumors with muscularis mucosa or SM1 invasion.…”

ASGE guideline on screening and surveillance of Barrett’s esophagus

“…We identified no studies that addressed the outcome of mortality and cancer progression. For the outcome of diagnostic characteristics of EUS in BE patients with dysplasia and early EAC, we started with 2 MAs by Qumseya et al 92,93 These analyses focused on the performance characteristics of EUS at the T1a versus T1b level using data from 11 studies. The pooled sensitivity, specificity, and accuracy from this analysis were 41% (95% CI, 35%-48%), 89% (95% CI, 86%-91%), and 75% (95% CI, 59%-86%), respectively.…”

Upregulation of miR-17-92 cluster is associated with progression and lymph node metastasis in oesophageal adenocarcinoma

“…in 2018 including a total of 895 Barrett oesophagus patients from 11 studies demonstrated that the pooled false positive rate for estimating an advanced disease (pT1a/b) via EUS was 9.1% ([6.5–12.5%], p < 0.001) while the pooled false negative rate was 9.2% ([95%CI: 4.7–17.3%], p < 0.01) 33 . That means that almost twenty percent of Barrett oesophagus patients were wrongly evaluated and therefore received the non-optimal treatment significantly reducing the pooled accuracy of EUS to 74.6% ([58.7–85.8%], p = 0.004) 33 . Other studies supported these findings 34–36 .…”