BACKGROUND & AIMS: The aim of this study was to assess the validity of frozen section analysis of endoscopic mucosal resection (EMR) specimens from Barrett's esophagus as compared with permanent sections for the detection of neoplasia. Frozen sections help to give immediate feedback for surgical procedures. It has not been determined whether EMR can be adequately interpreted by using frozen sections to aid endoscopists in completely resecting neoplastic lesions. METHODS: EMR specimens from Barrett's esophagus with high-grade dysplasia (HGD) and/or carcinoma were tested by frozen section. Pathologists evaluated EMR specimens for the depth of invasion as well as the appearance of clear margins of resection. The kappa statistic was calculated to assess the degree of agreement between the frozen section and permanent section diagnoses. RESULTS: Twenty-three consecutive patients underwent 30 EMRs with frozen section diagnosis. Frozen section revealed a carcinoma in 7 specimens (23%) and dysplasia in 20 (66%). Permanent sections found carcinoma in 8 specimens (26%), dysplasia in 19 specimens (63%), and normal or nondysplastic Barrett's esophagus in the remainder. The kappa statistic for the depth of invasion of EMR specimens was 0.93 (near perfect agreement). The kappa statistic for the margins of the EMR specimens was 0.80 (excellent agreement). CONCLUSIONS: This study indicated that frozen section analysis of esophageal EMR specimens is valid as compared with permanent section. This technique might allow rapid evaluation about the degree and depth of involvement of cancers. This allows physicians to make decisions regarding further therapy if margins are involved or decrease the use of EMR for histologically benign-appearing lesions.
BACKGROUND & AIMS: The aim of this study was to assess the validity of frozen section analysis of endoscopic mucosal resection (EMR) specimens from Barrett's esophagus as compared with permanent sections for the detection of neoplasia. Frozen sections help to give immediate feedback for surgical procedures. It has not been determined whether EMR can be adequately interpreted by using frozen sections to aid endoscopists in completely resecting neoplastic lesions. METHODS: EMR specimens from Barrett's esophagus with high-grade dysplasia (HGD) and/or carcinoma were tested by frozen section. Pathologists evaluated EMR specimens for the depth of invasion as well as the appearance of clear margins of resection. The kappa statistic was calculated to assess the degree of agreement between the frozen section and permanent section diagnoses. RESULTS: Twenty-three consecutive patients underwent 30 EMRs with frozen section diagnosis. Frozen section revealed a carcinoma in 7 specimens (23%) and dysplasia in 20 (66%). Permanent sections found carcinoma in 8 specimens (26%), dysplasia in 19 specimens (63%), and normal or nondysplastic Barrett's esophagus in the remainder. The kappa statistic for the depth of invasion of EMR specimens was 0.93 (near perfect agreement). The kappa statistic for the margins of the EMR specimens was 0.80 (excellent agreement). CONCLUSIONS: This study indicated that frozen section analysis of esophageal EMR specimens is valid as compared with permanent section. This technique might allow rapid evaluation about the degree and depth of involvement of cancers. This allows physicians to make decisions regarding further therapy if margins are involved or decrease the use of EMR for histologically benign-appearing lesions.
Authors: J J Nigro; J A Hagen; T R DeMeester; S R DeMeester; J H Peters; S Oberg; J Theisen; M Kiyabu; P F Crookes; C G Bremner Journal: J Thorac Cardiovasc Surg Date: 1999-01 Impact factor: 5.209
Authors: Ganapathy A Prasad; Kenneth K Wang; Navtej S Buttar; Louis-Michel Wongkeesong; Kausilia K Krishnadath; Francis C Nichols; Lori S Lutzke; Lynn S Borkenhagen Journal: Gastroenterology Date: 2007-02-07 Impact factor: 22.682
Authors: Ganapathy A Prasad; Kenneth K Wang; Kevin C Halling; Navtej S Buttar; Louis-Michel Wongkeesong; Alan R Zinsmeister; Shannon M Brankley; Emily G Barr Fritcher; Wytske M Westra; Kausilia K Krishnadath; Lori S Lutzke; Lynn S Borkenhagen Journal: Gastroenterology Date: 2008-05-07 Impact factor: 22.682
Authors: Rami J Badreddine; Ganapathy A Prasad; Jason T Lewis; Lori S Lutzke; Lynn S Borkenhagen; Kelly T Dunagan; Kenneth K Wang Journal: Clin Gastroenterol Hepatol Date: 2009-11-27 Impact factor: 11.382
Authors: Ganapathy A Prasad; Navtej S Buttar; Louis M Wongkeesong; Jason T Lewis; Schuyler O Sanderson; Lori S Lutzke; Lynn S Borkenhagen; Kenneth K Wang Journal: Am J Gastroenterol Date: 2007-07-19 Impact factor: 10.864
Authors: Ganapathy A Prasad; Kenneth K Wang; Kevin C Halling; Navtej S Buttar; Louis-Michel Wongkeesong; Alan R Zinsmeister; Shannon M Brankley; Wytske M Westra; Lori S Lutzke; Lynn S Borkenhagen; Kelly Dunagan Journal: Cancer Date: 2008-08-01 Impact factor: 6.860