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Risk for Esophageal Neoplasia in Barrett's Esophagus Patients with Mucosal Changes Indefinite for Dysplasia.
[esophageal adenocarcinoma]
Patients
with
Barrett
's
esophagus
(
BE
)
are
at
increased
risk
for
esophageal
adenocarcinoma
(
EAC
)
and
therefore
require
surveillance
.
Biopsies
are
classified
as
indefinite
for
dysplasia
(
IND
)
when
the
significance
of
epithelial
abnormalities
is
uncertain
due
to
inflammation
or
sampling
.
Our
aim
was
to
characterize
the
neoplastic
risk
of
IND
in
BE
patients
and
to
identify
predictors
of
neoplastic
risk
.
Our
pathology
database
from
1992
to
2007
was
searched
for
BE
and
IND
.
Progression
rates
were
calculated
and
univariate
analysis
was
performed
to
identify
predictors
for
neoplasia
progression
in
BE-IND
patients
.
Among
85
patients
who
had
a
follow-up
(
FU
)
biopsy
within
1
year
,
11
(
12
.
9
%
)
patients
had
prevalent
neoplasia
(
7
low
-grade
dysplasia
(
LGD
)
,
2
high
-grade
dysplasia
(
HGD
)
,
and
2
EAC
)
.
Among
82
patients
who
did
not
have
prevalent
neoplasia
but
had
≥
1
year
FU
,
17
progressed
to
dysplasia
(
14
LGD
,
3
HGD
)
and
2
developed
EAC
during
a
mean
FU
period
of
59
months
.
The
incidence
of
neoplasia
(
LGD
,
HGD
or
EAC
)
and
advanced
neoplasia
(
HGD
+
EAC
)
was
4
.
5
and
1
.
2
cases
per
100
patient-
years
,
respectively
.
Longer
length
of
BE
and
multi-
focal
IND
on
index
biopsy
were
associated
with
progression
to
neoplasia
.
Patients
with
BE-IND
carry
a
significant
risk
of
harboring
prevalent
dysplasia
,
but
the
risk
of
incident
dysplasia
is
similar
to
the
general
BE
population
.
The
length
of
BE
and
the
multifocal
IND
might
tentatively
help
to
identify
a
patient
subpopulation
at
higher
risk
of
neoplastic
progression
before
more
definitive
data
becomes
available
.
Diseases
Validation
Diseases presenting
"inflammation or sampling"
symptom
esophageal adenocarcinoma
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