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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
"neoplasia"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
carcinoma of the gallbladder
cholangiocarcinoma
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
hodgkin lymphoma, classical
liposarcoma
lymphangioleiomyomatosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
pleomorphic liposarcoma
primary effusion lymphoma
pyomyositis
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
This symptom has already been validated
