Barrett’s esophagus and reflux disease

Introduction

Very high quality clinical and translational research has been presented at the Digestive Disease Week (DDW) 2010 in New Orleans (1 – 5 May, New Orleans, Louisiana, USA). Here, a selection of the 16 best abstracts presented from the upper gastrointestinal field are briefly reviewed, with focus on Barrett’s esophagus and reflux-related diseases. In selecting the abstracts specific relevance has been given to the following three elements: the impact of studies on daily clinical practice; their contribution to the understanding of the natural history of diseases; and the translational potential to introduce new diagnostic tools.

References

• 1 Yousef F, Cardwell C, Cantwell M M. et al . The incidence of esophageal cancer and high-grade dysplasia in Barrett’s esophagus: a systematic review and meta-analysis.  Am J Epidemiol. 2008;  168 237-249
• 2 Wani S B, Falk G W, Hall M, Wang A. et al . Low risk of developing dysplasia and esophageal adenocarcinoma (EAC) in patients with non-dysplastic Barrett’s esophagus (BE): results from a large, multicenter, cohort study.  Gastroenterology. 2010;  138 S-63
• 3 Corley D A, Mehtani K, Zhao W. et al . Barrett’s esophagus surveillance and risk of death from esophageal adenocarcinoma: a case-control study.  Gastroenterology. 2010;  138 S-16
• 4 Ozde R D. Pathology of the gastroesophageal junction.  Semin Diagn Pathol. 2005;  22 256-265
• 5 Jung K W, Dunagan K T, Fredericksen M. et al . Natural history of intestinal metaplasia of the gastroesophageal junction in Olmsted County, MN: a population based cohort study.  Gastrointest Endosc. 2010;  71 AB121
• 6 Shariff K M, Bird-Lieberman E L, Vowler S L. et al . Nasal or standard endoscopy (NOSE) for diagnosis of Barrett’s oesophagus – efficacy and patient tolerance.  Gastrointest Endosc. 2010;  71 AB121
• 7 Kadri S R, Lao-Sirieix P, O’Donovan M. et al . A prospective, multicentre study to evaluate a novel non-endoscopic screening device for Barrett’s esophagus in the community setting.  Gastroenterology. 2010;  139 e17
• 8 Lao-Sirieix P, Boussioutas A, Kadri S R. et al . Non-endoscopic screening biomarkers for Barrett’s oesophagus: from microarray analysis to the clinic.  Gut. 2009;  58 1451-1459
• 9 Moran E A, Stark D K, Knipschield M A, Gostout C J. Comparison of chromoendoscopy directed biopsy vs. random biopsy endoscopic surveillance for Barrett’s esophagus – a prospective trial.  Gastrointest Endosc. 2010;  71 AB122
• 10 Ngamruengphong S, Sharma V K, Das A. Diagnostic yield of methylene blue chromoendoscopy for detecting specialized intestinal metaplasia and dysplasia in Barrett’s esophagus: a meta-analysis.  Gastrointest Endosc. 2009;  69 1021-1028
• 11 Pohl H, Rösch T, Vieth M. et al . Miniprobe confocal laser microscopy for the detection of invisible neoplasia in patients with Barrett’s oesophagus.  Gut. 2008;  57 1648-1653
• 12 Sharma P, Meining A, Coron E. et al . Detection of neoplastic tissue in Barrett’s esophagus with in vivo probe-based confocal endomicroscopy (DONT BIOPCE). Final results of a prospective international RCT: image guided versus 4 quadrant random biopsies?.  Gastroenterology. 2010;  138 S-155
• 13 Anastassiades C P, Li M, Turgeon D K, Piraka C R. Validation of targeted detection of dysplasia in Barrett’s esophagus with a novel fluorescence-labeled peptide.  Gastroenterology. 2010;  138 S-155-S-156
• 14 Fleischer D E, Overholt B F, Sharma V K. et al . Endoscopic ablation of Barrett’s esophagus: a multicenter study with 2.5-year follow-up.  Gastrointest Endosc. 2008;  68 867-876
• 15 Shaheen N J, Sharma P, Overholt B F. et al . Radiofrequency ablation in Barrett’s esophagus with dysplasia.  N Engl J Med. 2009;  360 2277-2288
• 16 Pouw R E, Bisschops R, Pech O. et al . Safety outcomes of balloon-based circumferential radiofrequency ablation after focal endoscopic resection of early Barrett’s neoplasia in 118 patients: results of an ongoing European multicenter study.  Gastrointest Endosc. 2010;  71 AB126
• 17 Pech O, Behrens A, May A. et al . Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus.  Gut. 2008;  57 1200-1206
• 18 Bergman J, Fleischer D E, Yueming Z. et al . First prospective study on endoscopic radiofrequency ablation of moderate and high-grade intraepithelial squamous neoplasia and early squamous cell cancer of the esophagus.  Gastrointest Endosc. 2010;  71 AB126
• 19 Fujishiro M, Yahagi N, Kakushima N. et al . Endoscopic submucosal dissection of esophageal squamous cell neoplasms.  Clin Gastroenterol Hepatol. 2006;  4 688-694
• 20 Kakushima N, Yahagi N, Fujishiro M. et al . Efficacy and safety of endoscopic submucosal dissection for tumors of the esophagogastric junction.  Endoscopy. 2006;  38 170-174
• 21 Deprez P H, Bergman J J, Meisner S. et al . Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts.  Endoscopy. 2010;  Jul 9 DOI: 10.1055/s-0030-1255563
• 22 Deprez P H, Piessevaux H, Aouattah T. et al . ESD in Barrett’s esophagus high grade dysplasia and mucosal cancer: prospective comparison with CAP mucosectomy.  Gastrointest Endosc. 2010;  71 AB126
• 23 Neuhaus H, Mayershofer R, Charton J P. et al . Endoscopic submucosal resection (ESD) of early Barrett’s neoplasia (EBN) with a Water-Jet Hybridknife (ESDH): first prospective clinical trial.  Gastrointest Endosc. 2010;  71 AB124
• 24 Neuhaus H, Wirths K, Schenk M. et al . Randomized controlled study of EMR versus endoscopic submucosal dissection with a water-jet hybrid-knife of esophageal lesions in a porcine model.  Gastrointest Endosc. 2009;  70 112-120
• 25 Badreddine R J, Prasad G A, Wang K K. et al . Prevalence and predictors of recurrent neoplasia after ablation of Barrett’s esophagus.  Gastrointest Endosc. 2010;  71 697-703
• 26 Halsey K D, Chang J W, Greenwald B D. Recurrent disease following endoscopic ablation of Barrett’s neoplasia.  Gastroenterology. 2010;  138 S-17
• 27 Galmiche J P, Hatlebakk J G, Attwood S E. et al . Laparoscopic antireflux surgery vs long-term esomeprazole treatment for chronic GERD. Final results after 5 yrs of follow up in the Lotus Study.  Gastroenterology. 2010;  138 S-53
• 28 Wadhwa R P, Kozarek R A, France R E. et al . Use of self-expandable metallic stents in benign GI diseases.  Gastrointest Endosc. 2003;  58 207-212
• 29 Leers J M, Vivaldi C, Schäfer H. et al . Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent.  Surg Endosc. 2009;  23 2258-2262
• 30 Swinnen J, Eisendrath P, Rigaux J. et al . Self-expandable metallic stents (SEMS) for the treatment of benign upper GI leaks and perforations.  Gastrointest Endosc. 2010;  71 AB132
• 31 Van Heel N, Haringsma J, Kuipers E J. Endoscopic extraction of self-expandable metal stents from the esophagus: outcome and complications in 107 procedures.  Gastrointest Endosc. 2010;  71 AB136

Additional references: Natural history of Barrett’s esophagus and intestinal metaplasia at the gastroesophageal junction

• 32 Caygill C P, Royston C, Charlett A. et al . Mortality in patients with Barrett’s esophagus (BE).   Gastroenterology. 2010;  138 S-16
• 33 Yousef F, Bhat S, Mulholland H G. et al . Low incidence of esophageal adenocarcinoma in Barrett’s esophagus – time to rethink surveillance guidelines?.  Gastroenterology. 2010;  138 S-16

Novel endoscopic and nonendoscopic diagnostic tools for Barrett’s esophagus

• 34 Arora J, Singh M, Gaddam S. et al . Accuracy and inter-observer variability of in-vivo probe-based confocal laser endomicroscopy criteria for dysplastic vs non dysplastic Barrett’s esophagus (BE).  Gastroenterology. 2010;  138 S-156
• 35 Curvers W L, van Vilsteren F G, Baak B C. et al . A multi-centre randomized cross-over trial comparing endoscopic tri-modal imaging (ETMI) with standard endoscopy (SE) for the detection of dysplasia in Barrett’s esophagus (BE) patients with confirmed LGD performed in a non-university setting.  Gastroenterology. 2010;  138 S-155
• 36 Terry N G, Zhu Y, Guy C D. et al . Detection of dysplasia in Barrett’s esophagus with angle-resolved low coherence interferometry.  Gastroenterology. 2010;  138 S-666

Treatment of dysplasia and early cancer in the esophagus

• 37 Fleischer D E, Overholt B F, Sharma V K. et al . Endoscopic radiofrequency ablation for Barrett’s esophagus: five-year durability outcomes from a prospective multi-center trial.   Gastrointest Endosc. 2010;  71 AB117-AB118
• 38 Gupta N, Abrams J A, Early D S. et al . Multi-modality endoscopic therapy for complete eradication of Barrett’s esophagus.  Gastroenterology. 2010;  139 e18
• 39 Shaheen N J, Fleischer D E, Eisen G M. et al . Durability of epithelial reversion after radiofrequency ablation: follow-up of the AIM dysplasia trial.  Gastroenterology. 2010;  138 S-16-S-17

Treatment of gastroesophageal reflux disease

• 40 Zehetner J, DeMeester S R, Ayazi S. et al . Long-term follow-up after anti-reflux surgery in patients with Barrett’s esophagus.  Gastroenterology. 2010;  138 S-849