Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00032260.xml
Digestive Disease Interventions 2021; 05(01): 009-016
DOI: 10.1055/s-0041-1726325
DOI: 10.1055/s-0041-1726325
Review Article
Evaluation of Barrett's Esophagus
Trent Walradt
1
Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Mohammad Bilal
2
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Center for Advanced Endoscopy, Harvard Medical School, Boston, Massachusetts
,
Douglas K. Pleskow
2
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Center for Advanced Endoscopy, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Abstract
Barrett's esophagus (BE) is the condition in which a metaplastic columnar epithelium that is predisposed to malignancy replaces the stratified squamous epithelium that normally lines the distal esophagus. BE develops as a consequence of chronic gastroesophageal reflux disease and predisposes to esophageal adenocarcinoma (EAC). Several societal guidelines recommend screening and surveillance for BE to reduce the risk of EAC and its related morbidity and mortality. Even among persons undergoing screening and surveillance, a substantial proportion of cases of EAC can be missed. Consequently, the armamentarium for the evaluation of BE has expanded rapidly over the past decade. In this article, we summarize the pathophysiology and diagnosis of BE. We also discuss the latest advancements in the evaluation of BE.
Publication History
Received: 09 October 2020
Accepted: 12 January 2021
Article published online:
18 March 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Cameron AJ, Zinsmeister AR, Ballard DJ, Carney JA. Prevalence of columnar-lined (Barrett's) esophagus. Comparison of population-based clinical and autopsy findings. Gastroenterology 1990; 99 (04) 918-922
- 2 Ronkainen J, Aro P, Storskrubb T. et al. Prevalence of Barrett's esophagus in the general population: an endoscopic study. Gastroenterology 2005; 129 (06) 1825-1831
- 3 Rex DK, Cummings OW, Shaw M. et al. Screening for Barrett's esophagus in colonoscopy patients with and without heartburn. Gastroenterology 2003; 125 (06) 1670-1677
- 4 Zagari RM, Fuccio L, Wallander M-A. et al. Gastro-oesophageal reflux symptoms, oesophagitis and Barrett's oesophagus in the general population: the Loiano-Monghidoro study. Gut 2008; 57 (10) 1354-1359
- 5 Spechler SJ. Barrett's esophagus. Semin Gastrointest Dis 1996; 7 (02) 51-60
- 6 Hassall E. Columnar-lined esophagus in children. Gastroenterol Clin North Am 1997; 26 (03) 533-548
- 7 Hassall E. Esophageal metaplasia: definition and prevalence in childhood. Gastrointest Endosc 2006; 64 (05) 676-677
- 8 Cook MB, Wild CP, Forman D. A systematic review and meta-analysis of the sex ratio for Barrett's esophagus, erosive reflux disease, and nonerosive reflux disease. Am J Epidemiol 2005; 162 (11) 1050-1061
- 9 Abrams JA, Fields S, Lightdale CJ, Neugut AI. Racial and ethnic disparities in the prevalence of Barrett's esophagus among patients who undergo upper endoscopy. Clin Gastroenterol Hepatol 2008; 6 (01) 30-34
- 10 Corley DA, Kubo A, Levin TR. et al. Race, ethnicity, sex and temporal differences in Barrett's oesophagus diagnosis: a large community-based study, 1994-2006. Gut 2009; 58 (02) 182-188
- 11 Ronkainen J, Talley NJ, Storskrubb T. et al. Erosive esophagitis is a risk factor for Barrett's esophagus: a community-based endoscopic follow-up study. Am J Gastroenterol 2011; 106 (11) 1946-1952
- 12 Conio M, Filiberti R, Blanchi S. et al; Gruppo Operativo per lo Studio delle Precancerosi Esofagee (GOSPE). Risk factors for Barrett's esophagus: a case-control study. Int J Cancer 2002; 97 (02) 225-229
- 13 Johansson J, Håkansson H-O, Mellblom L. et al. Risk factors for Barrett's oesophagus: a population-based approach. Scand J Gastroenterol 2007; 42 (02) 148-156
- 14 Kamat P, Wen S, Morris J, Anandasabapathy S. Exploring the association between elevated body mass index and Barrett's esophagus: a systematic review and meta-analysis. Ann Thorac Surg 2009; 87 (02) 655-662
- 15 Kramer JR, Fischbach LA, Richardson P. et al. Waist-to-hip ratio, but not body mass index, is associated with an increased risk of Barrett's esophagus in white men. Clin Gastroenterol Hepatol 2013; 11 (04) 373-381.e1
- 16 Edelstein ZR, Farrow DC, Bronner MP, Rosen SN, Vaughan TL. Central adiposity and risk of Barrett's esophagus. Gastroenterology 2007; 133 (02) 403-411
- 17 Corley DA, Kubo A, Levin TR. et al. Abdominal obesity and body mass index as risk factors for Barrett's esophagus. Gastroenterology 2007; 133 (01) 34-41 , quiz 311
- 18 Andrici J, Cox MR, Eslick GD. Cigarette smoking and the risk of Barrett's esophagus: a systematic review and meta-analysis. J Gastroenterol Hepatol 2013; 28 (08) 1258-1273
- 19 Qumseya BJ, Bukannan A, Gendy S. et al. Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus. Gastrointest Endosc 2019; 90 (05) 707-717.e1
- 20 Omer ZB, Ananthakrishnan AN, Nattinger KJ. et al. Aspirin protects against Barrett's esophagus in a multivariate logistic regression analysis. Clin Gastroenterol Hepatol 2012; 10 (07) 722-727
- 21 Nguyen DM, Richardson P, El-Serag HB. Medications (NSAIDs, statins, proton pump inhibitors) and the risk of esophageal adenocarcinoma in patients with Barrett's esophagus. Gastroenterology 2010; 138 (07) 2260-2266
- 22 Souza RF, Shewmake K, Beer DG, Cryer B, Spechler SJ. Selective inhibition of cyclooxygenase-2 suppresses growth and induces apoptosis in human esophageal adenocarcinoma cells. Cancer Res 2000; 60 (20) 5767-5772
- 23 Erőss B, Farkas N, Vincze Á. et al. Helicobacter pylori infection reduces the risk of Barrett's esophagus: a meta-analysis and systematic review. Helicobacter 2018; 23 (04) e12504
- 24 Iijima K, Henry E, Moriya A, Wirz A, Kelman AW, McColl KEL. Dietary nitrate generates potentially mutagenic concentrations of nitric oxide at the gastroesophageal junction. Gastroenterology 2002; 122 (05) 1248-1257
- 25 Dvorak K, Payne CM, Chavarria M. et al. Bile acids in combination with low pH induce oxidative stress and oxidative DNA damage: relevance to the pathogenesis of Barrett's oesophagus. Gut 2007; 56 (06) 763-771
- 26 Iftikhar SY, Ledingham S, Steele RJ. et al. Bile reflux in columnar-lined Barrett's oesophagus. Ann R Coll Surg Engl 1993; 75 (06) 411-416
- 27 Que J, Garman KS, Souza RF, Spechler SJ. Pathogenesis and cells of origin of Barrett's esophagus. Gastroenterology 2019; 157 (02) 349-364.e1
- 28 Sarosi G, Brown G, Jaiswal K. et al. Bone marrow progenitor cells contribute to esophageal regeneration and metaplasia in a rat model of Barrett's esophagus. Dis Esophagus 2008; 21 (01) 43-50
- 29 Quante M, Bhagat G, Abrams JA. et al. Bile acid and inflammation activate gastric cardia stem cells in a mouse model of Barrett-like metaplasia. Cancer Cell 2012; 21 (01) 36-51
- 30 Wang X, Ouyang H, Yamamoto Y. et al. Residual embryonic cells as precursors of a Barrett's-like metaplasia. Cell 2011; 145 (07) 1023-1035
- 31 McClave SA, Boyce Jr HW, Gottfried MR. Early diagnosis of columnar-lined esophagus: a new endoscopic diagnostic criterion. Gastrointest Endosc 1987; 33 (06) 413-416
- 32 Fitzgerald RC, di Pietro M, Ragunath K. et al; British Society of Gastroenterology. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus. Gut 2014; 63 (01) 7-42
- 33 Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG clinical guideline: diagnosis and management of Barrett's esophagus. Am Coll Gastroenterol 2016; 111 (01) 30-50
- 34 Sharma P, Dent J, Armstrong D. et al. The development and validation of an endoscopic grading system for Barrett's esophagus: the Prague C & M criteria. Gastroenterology 2006; 131 (05) 1392-1399
- 35 Wani S, Rubenstein JH, Vieth M, Bergman J. Diagnosis and management of low-grade dysplasia in Barrett's esophagus: expert review from the Clinical Practice Updates Committee of the American Gastroenterological Association. Gastroenterology 2016; 151 (05) 822-835
- 36 Levine DS, Blount PL, Rudolph RE, Reid BJ. Safety of a systematic endoscopic biopsy protocol in patients with Barrett's esophagus. Am J Gastroenterol 2000; 95 (05) 1152-1157
- 37 Fitzgerald RC, Saeed IT, Khoo D, Farthing MJG, Burnham WR. Rigorous surveillance protocol increases detection of curable cancers associated with Barrett's esophagus. Dig Dis Sci 2001; 46 (09) 1892-1898
- 38 Abela J-E, Going JJ, Mackenzie JF, McKernan M, O'Mahoney S, Stuart RC. Systematic four-quadrant biopsy detects Barrett's dysplasia in more patients than nonsystematic biopsy. Am J Gastroenterol 2008; 103 (04) 850-855
- 39 Hanna S, Rastogi A, Weston AP. et al. Detection of Barrett's esophagus after endoscopic healing of erosive esophagitis. Am J Gastroenterol 2006; 101 (07) 1416-1420
- 40 Modiano N, Gerson LB. Risk factors for the detection of Barrett's esophagus in patients with erosive esophagitis. Gastrointest Endosc 2009; 69 (06) 1014-1020
- 41 Codipilly DC, Chandar AK, Singh S. et al. The effect of endoscopic surveillance in patients with Barrett's esophagus: a systematic review and meta-analysis. Gastroenterology 2018; 154 (08) 2068-2086.e5
- 42 Visrodia K, Singh S, Krishnamoorthi R. et al. Magnitude of missed esophageal adenocarcinoma after Barrett's esophagus diagnosis: a systematic review and meta-analysis. Gastroenterology 2016; 150 (03) 599-607.e7 , quiz e14–e15
- 43 Abrams JA, Kapel RC, Lindberg GM. et al. Adherence to biopsy guidelines for Barrett's esophagus surveillance in the community setting in the United States. Clin Gastroenterol Hepatol 2009; 7 (07) 736-742 , quiz 710
- 44 Wong Kee Song LM, Adler DG, Chand B. et al; ASGE Technology Committee. Chromoendoscopy. Gastrointest Endosc 2007; 66 (04) 639-649
- 45 Guelrud M, Herrera I, Essenfeld H, Castro J. Enhanced magnification endoscopy: a new technique to identify specialized intestinal metaplasia in Barrett's esophagus. Gastrointest Endosc 2001; 53 (06) 559-565
- 46 Tholoor S, Bhattacharyya R, Tsagkournis O, Longcroft-Wheaton G, Bhandari P. Acetic acid chromoendoscopy in Barrett's esophagus surveillance is superior to the standardized random biopsy protocol: results from a large cohort study (with video). Gastrointest Endosc 2014; 80 (03) 417-424
- 47 Thosani N, Abu Dayyeh BK, Sharma P. et al; ASGE Technology Committee. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus. Gastrointest Endosc 2016; 83 (04) 684-98.e7
- 48 Ngamruengphong S, Sharma VK, 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 (06) 1021-1028
- 49 Sharma P, Savides TJ, Canto MI. et al; ASGE Technology and Standards of Practice Committee. The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on imaging in Barrett's Esophagus. Gastrointest Endosc 2012; 76 (02) 252-254
- 50 Meining A, Rösch T, Kiesslich R, Muders M, Sax F, Heldwein W. Inter- and intra-observer variability of magnification chromoendoscopy for detecting specialized intestinal metaplasia at the gastroesophageal junction. Endoscopy 2004; 36 (02) 160-164
- 51 Olliver JR, Wild CP, Sahay P, Dexter S, Hardie LJ. Chromoendoscopy with methylene blue and associated DNA damage in Barrett's oesophagus. Lancet 2003; 362 (9381): 373-374
- 52 Kondo H, Fukuda H, Ono H. et al. Sodium thiosulfate solution spray for relief of irritation caused by Lugol's stain in chromoendoscopy. Gastrointest Endosc 2001; 53 (02) 199-202
- 53 Olympus America. NBI: Barrett's Esophagus. Accessed August 30, 2020. Accessed February 15, 2021 at: https://olympusamerica.com/01_NBI_Barretts_Esophagus_WebVersion_01/
- 54 Hamamoto Y, Endo T, Nosho K, Arimura Y, Sato M, Imai K. Usefulness of narrow-band imaging endoscopy for diagnosis of Barrett's esophagus. J Gastroenterol 2004; 39 (01) 14-20
- 55 Sharma P, Hawes RH, Bansal A. et al. Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett's oesophagus: a prospective, international, randomised controlled trial. Gut 2013; 62 (01) 15-21
- 56 Everson MA, Lovat LB, Graham DG. et al. Virtual chromoendoscopy by using optical enhancement improves the detection of Barrett's esophagus-associated neoplasia. Gastrointest Endosc 2019; 89 (02) 247-256.e4
- 57 Qumseya B, Sultan S, Bain P. et al; ASGE STANDARDS OF PRACTICE COMMITTEE, ASGE Standards of Practice Committee Chair. ASGE guideline on screening and surveillance of Barrett's esophagus. Gastrointest Endosc 2019; 90 (03) 335-359.e2
- 58 Johanson JF, Frakes J, Eisen D. EndoCDx Collaborative Group. Computer-assisted analysis of abrasive transepithelial brush biopsies increases the effectiveness of esophageal screening: a multicenter prospective clinical trial by the EndoCDx Collaborative Group. Dig Dis Sci 2011; 56 (03) 767-772
- 59 Smith MS, Ikonomi E, Bhuta R. et al; US Collaborative WATS Study Group. Wide-area transepithelial sampling with computer-assisted 3-dimensional analysis (WATS) markedly improves detection of esophageal dysplasia and Barrett's esophagus: analysis from a prospective multicenter community-based study. Dis Esophagus 2019; 32 (03) doy099
- 60 Singer ME, Smith MS. Wide Area Transepithelial Sampling with Computer-Assisted Analysis (WATS3D) is cost-effective in Barrett's esophagus screening. Dig Dis Sci 2020; ; (epub ahead of print)
- 61 Chauhan SS, Dayyeh BKA, Bhat YM. et al; ASGE Technology Committee. Confocal laser endomicroscopy. Gastrointest Endosc 2014; 80 (06) 928-938
- 62 Othman MO, Wallace MB. Confocal laser endomicroscopy: Is it prime time?. J Clin Gastroenterol 2011; 45 (03) 205-206
- 63 Kiesslich R, Gossner L, Goetz M. et al. In vivo histology of Barrett's esophagus and associated neoplasia by confocal laser endomicroscopy. Clin Gastroenterol Hepatol 2006; 4 (08) 979-987
- 64 Dunbar KB, Okolo III P, Montgomery E, Canto MI. Confocal laser endomicroscopy in Barrett's esophagus and endoscopically inapparent Barrett's neoplasia: a prospective, randomized, double-blind, controlled, crossover trial. Gastrointest Endosc 2009; 70 (04) 645-654
- 65 Wallace MB, Meining A, Canto MI. et al. The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. Aliment Pharmacol Ther 2010; 31 (05) 548-552
- 66 Trindade AJ, Smith MS, Pleskow DK. The new kid on the block for advanced imaging in Barrett's esophagus: a review of volumetric laser endomicroscopy. Therap Adv Gastroenterol 2016; 9 (03) 408-416
- 67 Evans JA, Poneros JM, Bouma BE. et al. Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett's esophagus. Clin Gastroenterol Hepatol 2006; 4 (01) 38-43
- 68 Trindade AJ, Leggett CL, Chang KJ. Volumetric laser endomicroscopy in the management of Barrett's esophagus. Curr Opin Gastroenterol 2017; 33 (04) 254-260
- 69 Alshelleh M, Inamdar S, McKinley M. et al. Incremental yield of dysplasia detection in Barrett's esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol. Gastrointest Endosc 2018; 88 (01) 35-42
- 70 Qumseya BJ, Bartel MJ, Gendy S, Bain P, Qumseya A, Wolfsen H. High rate of over-staging of Barrett's neoplasia with endoscopic ultrasound: systemic review and meta-analysis. Dig Liver Dis 2018; 50 (05) 438-445
- 71 Sami SS, Dunagan KT, Johnson ML. et al. A randomized comparative effectiveness trial of novel endoscopic techniques and approaches for Barrett's esophagus screening in the community. Am J Gastroenterol 2015; 110 (01) 148-158
- 72 Spechler SJ, Katzka DA, Fitzgerald RC. New screening techniques in Barrett's esophagus: Great ideas or great practice?. Gastroenterology 2018; 154 (06) 1594-1601
- 73 Kawai T, Yamamoto K, Fukuzawa M, Sakai Y, Moriyasu F. [Ultra-thin transnasal esophagogastroduodenoscopy]. Nihon Rinsho 2010; 68 (07) 1264-1267
- 74 Kadri SR, Lao-Sirieix P, O'Donovan M. et al. Acceptability and accuracy of a non-endoscopic screening test for Barrett's oesophagus in primary care: cohort study. BMJ 2010; 341: c4372
- 75 Lao-Sirieix P, Boussioutas A, Kadri SR. et al. Non-endoscopic screening biomarkers for Barrett's oesophagus: from microarray analysis to the clinic. Gut 2009; 58 (11) 1451-1459
- 76 Fitzgerald RC, di Pietro M, O'Donovan M. et al; BEST3 Trial Team. Cytosponge-trefoil factor 3 versus usual care to identify Barrett's oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial. Lancet 2020; 396 (10247): 333-344
- 77 Heberle CR, Omidvari A-H, Ali A. et al. Cost effectiveness of screening patients with gastroesophageal reflux disease for Barrett's esophagus with a minimally invasive cell sampling device. Clin Gastroenterol Hepatol 2017; 15 (09) 1397-1404.e7
- 78 Moinova H, Leidner RS, Ravi L. et al. Aberrant vimentin methylation is characteristic of upper gastrointestinal pathologies. Cancer Epidemiol Biomarkers Prev 2012; 21 (04) 594-600
- 79 Moinova HR, LaFramboise T, Lutterbaugh JD. et al. Identifying DNA methylation biomarkers for non-endoscopic detection of Barrett's esophagus. Sci Transl Med 2018; 10 (424) eaao5848
- 80 Stachler MD, Camarda ND, Deitrick C. et al. Detection of mutations in Barrett's esophagus before progression to high-grade dysplasia or adenocarcinoma. Gastroenterology 2018; 155 (01) 156-167
- 81 Snyder P, Dunbar K, Cipher DJ, Souza RF, Spechler SJ, Konda VJA. Aberrant p53 immunostaining in Barrett's esophagus predicts neoplastic progression: systematic review and meta-analyses. Dig Dis Sci 2019; 64 (05) 1089-1097
- 82 Kaye PV, Haider SA, Ilyas M. et al. Barrett's dysplasia and the Vienna classification: reproducibility, prediction of progression and impact of consensus reporting and p53 immunohistochemistry. Histopathology 2009; 54 (06) 699-712