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.
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: K Krishnan; S Komanduri; J Cluley; R Dirisina; P Sinh; Jeff Z Ko; L Li; R B Katzman; T A Barrett Journal: Dig Dis Sci Date: 2011-09-24 Impact factor: 3.199
Authors: Chin Hur; Sung Eun Choi; Joel H Rubenstein; Chung Yin Kong; Norman S Nishioka; Dawn T Provenzale; John M Inadomi Journal: Gastroenterology Date: 2012-05-21 Impact factor: 22.682
Authors: Angelique Levert-Mignon; Michael J Bourke; Sarah J Lord; Andrew C Taylor; Antony R Wettstein; Melanie Edwards; Natalia K Botelho; Rebecca Sonson; Chatura Jayasekera; Oliver M Fisher; Melissa L Thomas; Finlay Macrae; Damian J Hussey; David I Watson; Reginald V Lord Journal: United European Gastroenterol J Date: 2016-07-07 Impact factor: 4.623
Authors: Cathy Bennett; Nimish Vakil; Jacques Bergman; Rebecca Harrison; Robert Odze; Michael Vieth; Scott Sanders; Laura Gay; Oliver Pech; Gaius Longcroft-Wheaton; Yvonne Romero; John Inadomi; Jan Tack; Douglas A Corley; Hendrik Manner; Susi Green; David Al Dulaimi; Haythem Ali; Bill Allum; Mark Anderson; Howard Curtis; Gary Falk; M Brian Fennerty; Grant Fullarton; Kausilia Krishnadath; Stephen J Meltzer; David Armstrong; Robert Ganz; Gianpaolo Cengia; James J Going; John Goldblum; Charles Gordon; Heike Grabsch; Chris Haigh; Michio Hongo; David Johnston; Ricky Forbes-Young; Elaine Kay; Philip Kaye; Toni Lerut; Laurence B Lovat; Lars Lundell; Philip Mairs; Tadakuza Shimoda; Stuart Spechler; Stephen Sontag; Peter Malfertheiner; Iain Murray; Manoj Nanji; David Poller; Krish Ragunath; Jaroslaw Regula; Renzo Cestari; Neil Shepherd; Rajvinder Singh; Hubert J Stein; Nicholas J Talley; Jean-Paul Galmiche; Tony C K Tham; Peter Watson; Lisa Yerian; Massimo Rugge; Thomas W Rice; John Hart; Stuart Gittens; David Hewin; Juergen Hochberger; Peter Kahrilas; Sean Preston; Richard Sampliner; Prateek Sharma; Robert Stuart; Kenneth Wang; Irving Waxman; Chris Abley; Duncan Loft; Ian Penman; Nicholas J Shaheen; Amitabh Chak; Gareth Davies; Lorna Dunn; Yngve Falck-Ytter; John Decaestecker; Pradeep Bhandari; Christian Ell; S Michael Griffin; Stephen Attwood; Hugh Barr; John Allen; Mark K Ferguson; Paul Moayyedi; Janusz A Z Jankowski Journal: Gastroenterology Date: 2012-04-24 Impact factor: 22.682
Authors: Nicholas J Shaheen; Bergein F Overholt; Richard E Sampliner; Herbert C Wolfsen; Kenneth K Wang; David E Fleischer; Virender K Sharma; Glenn M Eisen; M Brian Fennerty; John G Hunter; Mary P Bronner; John R Goldblum; Ana E Bennett; Hiroshi Mashimo; Richard I Rothstein; Stuart R Gordon; Steven A Edmundowicz; Ryan D Madanick; Anne F Peery; V Raman Muthusamy; Kenneth J Chang; Michael B Kimmey; Stuart J Spechler; Ali A Siddiqui; Rhonda F Souza; Anthony Infantolino; John A Dumot; Gary W Falk; Joseph A Galanko; Blair A Jobe; Robert H Hawes; Brenda J Hoffman; Prateek Sharma; Amitabh Chak; Charles J Lightdale Journal: Gastroenterology Date: 2011-05-06 Impact factor: 22.682
Authors: Nicholas J Shaheen; Anne F Peery; Bergein F Overholt; Charles J Lightdale; Amitabh Chak; Kenneth K Wang; Robert H Hawes; David E Fleischer; John R Goldblum Journal: Gastrointest Endosc Date: 2010-07-03 Impact factor: 9.427
Authors: Stuart Jon Spechler; Rebecca C Fitzgerald; Ganapathy A Prasad; Kenneth K Wang Journal: Gastroenterology Date: 2010-01-18 Impact factor: 22.682