Tags

Type your tag names separated by a space and hit enter

Properties of the neosquamous epithelium after radiofrequency ablation of Barrett's esophagus containing neoplasia.
Am J Gastroenterol. 2009 Jun; 104(6):1366-73.AJ

Abstract

OBJECTIVES

Endoscopic radiofrequency ablation (RFA) eradicates intestinal metaplasia and intraepithelial neoplasia associated with Barrett's esophagus (BE), restoring an endoscopically normal neosquamous epithelium (NSE). We evaluated the post-RFA NSE for genetic abnormalities and buried glandular mucosa.

METHODS

Eligible patients underwent RFA for BE containing early cancer and/or high-grade intraepithelial neoplasia with subsequent complete histological reversion to normal NSE. At baseline, the BE was sampled by brush cytology and biopsies. At least 2 months after RFA, the NSE was sampled by brush cytology, keyhole biopsies, and endoscopic resection. The untreated squamous epithelium was biopsied as a control. The baseline BE and post-RFA NSE were evaluated for immunohistochemical expression of Ki-67 and p53, and genetic abnormalities (DNA-fluorescent in situ hybridization: chromosome 1 and 9, p16 and p53). In addition, biopsy depth was compared for biopsies from the NSE and untreated squamous epithelium. The presence of buried glandular mucosa in NSE was assessed with primary and keyhole biopsy, and endoscopic resection.

RESULTS

All pretreatment specimens from all 22 patients showed abnormalities on immunohistochemical staining and fluorescent in situ hybridization, whereas all post-RFA NSE specimens were normal. All the post-RFA biopsies from the NSE contained full epithelia, whereas 37% contained lamina propria, a finding no different from biopsies from untreated squamous epithelium (36% lamina propria). Deeper keyhole biopsies contained lamina propria in 51%. All endoscopic resection specimens contained submucosa, whereas no biopsy or endoscopic resection specimen contained buried glandular mucosa.

CONCLUSIONS

Rigorous evaluation of the post-RFA NSE in patients who, at baseline, had BE containing early cancer high-grade intraepithelial neoplasia, showed neither persistent genetic abnormalities nor buried glandular mucosa.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19491850

Citation

Pouw, Roos E., et al. "Properties of the Neosquamous Epithelium After Radiofrequency Ablation of Barrett's Esophagus Containing Neoplasia." The American Journal of Gastroenterology, vol. 104, no. 6, 2009, pp. 1366-73.
Pouw RE, Gondrie JJ, Rygiel AM, et al. Properties of the neosquamous epithelium after radiofrequency ablation of Barrett's esophagus containing neoplasia. Am J Gastroenterol. 2009;104(6):1366-73.
Pouw, R. E., Gondrie, J. J., Rygiel, A. M., Sondermeijer, C. M., ten Kate, F. J., Odze, R. D., Vieth, M., Krishnadath, K. K., & Bergman, J. J. (2009). Properties of the neosquamous epithelium after radiofrequency ablation of Barrett's esophagus containing neoplasia. The American Journal of Gastroenterology, 104(6), 1366-73. https://doi.org/10.1038/ajg.2009.88
Pouw RE, et al. Properties of the Neosquamous Epithelium After Radiofrequency Ablation of Barrett's Esophagus Containing Neoplasia. Am J Gastroenterol. 2009;104(6):1366-73. PubMed PMID: 19491850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Properties of the neosquamous epithelium after radiofrequency ablation of Barrett's esophagus containing neoplasia. AU - Pouw,Roos E, AU - Gondrie,Joep J, AU - Rygiel,Agnieszka M, AU - Sondermeijer,Carine M, AU - ten Kate,Fiebo J, AU - Odze,Robert D, AU - Vieth,Michael, AU - Krishnadath,Kausilia K, AU - Bergman,Jacques J, Y1 - 2009/04/21/ PY - 2009/6/4/entrez PY - 2009/6/6/pubmed PY - 2009/6/24/medline SP - 1366 EP - 73 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 104 IS - 6 N2 - OBJECTIVES: Endoscopic radiofrequency ablation (RFA) eradicates intestinal metaplasia and intraepithelial neoplasia associated with Barrett's esophagus (BE), restoring an endoscopically normal neosquamous epithelium (NSE). We evaluated the post-RFA NSE for genetic abnormalities and buried glandular mucosa. METHODS: Eligible patients underwent RFA for BE containing early cancer and/or high-grade intraepithelial neoplasia with subsequent complete histological reversion to normal NSE. At baseline, the BE was sampled by brush cytology and biopsies. At least 2 months after RFA, the NSE was sampled by brush cytology, keyhole biopsies, and endoscopic resection. The untreated squamous epithelium was biopsied as a control. The baseline BE and post-RFA NSE were evaluated for immunohistochemical expression of Ki-67 and p53, and genetic abnormalities (DNA-fluorescent in situ hybridization: chromosome 1 and 9, p16 and p53). In addition, biopsy depth was compared for biopsies from the NSE and untreated squamous epithelium. The presence of buried glandular mucosa in NSE was assessed with primary and keyhole biopsy, and endoscopic resection. RESULTS: All pretreatment specimens from all 22 patients showed abnormalities on immunohistochemical staining and fluorescent in situ hybridization, whereas all post-RFA NSE specimens were normal. All the post-RFA biopsies from the NSE contained full epithelia, whereas 37% contained lamina propria, a finding no different from biopsies from untreated squamous epithelium (36% lamina propria). Deeper keyhole biopsies contained lamina propria in 51%. All endoscopic resection specimens contained submucosa, whereas no biopsy or endoscopic resection specimen contained buried glandular mucosa. CONCLUSIONS: Rigorous evaluation of the post-RFA NSE in patients who, at baseline, had BE containing early cancer high-grade intraepithelial neoplasia, showed neither persistent genetic abnormalities nor buried glandular mucosa. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/19491850/Properties_of_the_neosquamous_epithelium_after_radiofrequency_ablation_of_Barrett's_esophagus_containing_neoplasia_ L2 - http://Insights.ovid.com/pubmed?pmid=19491850 DB - PRIME DP - Unbound Medicine ER -