Benefits of the Seattle Biopsy Protocol in the Diagnosis of Barrett's Esophagus in a Chinese Population

Overview

Journal World J Clin Cases

Publisher Baishideng Publishing Group

Specialty General Medicine

Date 2018 Dec 5

PMID 30510939

Citations 1

Authors

Shou-Wu Lee

Han-Chung Lien

Chi-Sen Chang

Ming-Xian Lin

Chung-Hsin Chang

Chung-Wang Ko

Affiliations

Soon will be listed here.

Abstract

Aim: To investigate the benefits of the Seattle protocol in the diagnosis of Chinese individuals with Barrett's esophagus.

Methods: Subjects enrolled were patients from one center with endoscopically-suspected esophageal metaplasia. These patients first received narrow-band imaging-targeted biopsy, and later, the Seattle protocol-guided biopsy, within a period from October 2012 to December 2014. Those cases without initial pathologic patterns of intestinal metaplasia (IM) and then appearance or loss of IM tissue were designated as Group A or B, respectively. Those with initial pathologic patterns of IM, which then persisted or were lost were designated as Group C or D, respectively.

Results: The number of cases for each group was as follows: A: 20, B: 78, C: 31 and D: 14. The distribution of the Prague criteria M levels of Group A was significantly higher than Group B ( = 0.174). Among these groups, Group C had the highest proportions of hiatus hernia (54.8%), long segment Barrett's esophagus (29%), and also the highest Prague criteria M levels. The sensitivity of IM detection was 69.2% for the narrow-band imaging-targeted biopsy and 78.5% for the Seattle protocol-guided biopsy. The difference was not significant ( = 0.231). The number of detectable dysplasias increased from one case the NBI-target biopsy to five cases the Seattle protocol-guided biopsy, including one case of adenocarcinoma.

Conclusion: The Seattle protocol improved the IM detection in our subjects with higher Prague criteria M levels and disclosed more cases with dysplastic tissues.

Citing Articles

Diagnosis and Management of Barrett's Esophagus.

Mejza M, Malecka-Wojciesko E J Clin Med. 2023; 12(6).

PMID: 36983142 PMC: 10057256. DOI: 10.3390/jcm12062141.

References

Harrison R, Perry I, Haddadin W, McDonald S, Bryan R, Abrams K . Detection of intestinal metaplasia in Barrett's esophagus: an observational comparator study suggests the need for a minimum of eight biopsies. Am J Gastroenterol. 2007; 102(6):1154-61. DOI: 10.1111/j.1572-0241.2007.01230.x. View

Shaheen N, Falk G, Iyer P, Gerson L . ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol. 2015; 111(1):30-50. PMC: 10245082. DOI: 10.1038/ajg.2015.322. View

Wolfsen H, Crook J, Krishna M, Achem S, DeVault K, Bouras E . Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. Gastroenterology. 2008; 135(1):24-31. DOI: 10.1053/j.gastro.2008.03.019. View

Levine D . Management of dysplasia in the columnar-lined esophagus. Gastroenterol Clin North Am. 1997; 26(3):613-34. DOI: 10.1016/s0889-8553(05)70318-6. View

Sharma P, Dent J, Armstrong D, Bergman J, Gossner L, Hoshihara Y . The development and validation of an endoscopic grading system for Barrett's esophagus: the Prague C & M criteria. Gastroenterology. 2006; 131(5):1392-9. DOI: 10.1053/j.gastro.2006.08.032. View

Singh A, Chak A . Advances in the management of Barrett's esophagus and early esophageal adenocarcinoma. Gastroenterol Rep (Oxf). 2015; 3(4):303-15. PMC: 4650977. DOI: 10.1093/gastro/gov048. View

Shiota S, Singh S, Anshasi A, El-Serag H . Prevalence of Barrett's Esophagus in Asian Countries: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2015; 13(11):1907-18. PMC: 4615528. DOI: 10.1016/j.cgh.2015.07.050. View

Shaheen N, Richter J . Barrett's oesophagus. Lancet. 2009; 373(9666):850-61. DOI: 10.1016/S0140-6736(09)60487-6. View

Wani S, Rubenstein J, 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(5):822-835. DOI: 10.1053/j.gastro.2016.09.040. View

10.

Sharma P, Hawes R, Bansal A, Gupta N, Curvers W, Rastogi A . Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett's oesophagus: a prospective, international, randomised controlled trial. Gut. 2012; 62(1):15-21. DOI: 10.1136/gutjnl-2011-300962. View

11.

Mandal A, Playford R, Wicks A . Current practice in surveillance strategy for patients with Barrett's oesophagus in the UK. Aliment Pharmacol Ther. 2003; 17(10):1319-24. DOI: 10.1046/j.1365-2036.2003.01586.x. View

12.

Rustgi A, El-Serag H . Esophageal carcinoma. N Engl J Med. 2014; 371(26):2499-509. DOI: 10.1056/NEJMra1314530. View

13.

Abrams J, Kapel R, Lindberg G, Saboorian M, Genta R, Neugut A . Adherence to biopsy guidelines for Barrett's esophagus surveillance in the community setting in the United States. Clin Gastroenterol Hepatol. 2009; 7(7):736-42. PMC: 3139243. DOI: 10.1016/j.cgh.2008.12.027. View

14.

Runge T, Abrams J, Shaheen N . Epidemiology of Barrett's Esophagus and Esophageal Adenocarcinoma. Gastroenterol Clin North Am. 2015; 44(2):203-31. PMC: 4449458. DOI: 10.1016/j.gtc.2015.02.001. View

15.

Dulai G . Surveying the case for surveillance. Gastroenterology. 2002; 122(3):820-3. DOI: 10.1053/gast.2002.32093. View

16.

Sharma P, Morales T, Sampliner R . Short segment Barrett's esophagus--the need for standardization of the definition and of endoscopic criteria. Am J Gastroenterol. 1998; 93(7):1033-6. DOI: 10.1111/j.1572-0241.1998.00324.x. View

17.

Eloubeidi M, Provenzale D . Does this patient have Barrett's esophagus? The utility of predicting Barrett's esophagus at the index endoscopy. Am J Gastroenterol. 1999; 94(4):937-43. DOI: 10.1111/j.1572-0241.1999.990_m.x. View

18.

Amamra N, Touzet S, Colin C, Ponchon T . Current practice compared with the international guidelines: endoscopic surveillance of Barrett's esophagus. J Eval Clin Pract. 2007; 13(5):789-94. DOI: 10.1111/j.1365-2753.2006.00754.x. View