Neoplasia of Barrett’s esophagus: modern concepts of endoscopic diagnostics and experience of the P.A. Herzen Moscow Oncology Research Institute
https://doi.org/10.31146/1682-8658-ecg-237-5-18-23
Abstract
Barrett’s esophagus (BE) is an precancerous condition in which the squamous epithelium of the esophagus is transformed into a columnar epithelium under the influence of the constant reflux of acid. Barrett’s esophagus precedes the development of adenocarcinoma, the incidence of which, according to various authors, has increased significantly over the past decades. However, with timely detection and treatment of Barrett’s esophagus and dysplasia, it is possible to stop neoplastic progression and, subsequently, affect the reduction of mortality from invasive adenocarcinoma of the esophagus. In the endoscopy department of the P.A. Herzen Moscow Oncology Research Institute, 760 patients were examined in 2012-2024, in whom Barrett’s esophagus was detected during upper endoscopy. The disease was detected in men 2 times more often than in women (526 vs 254). In more than half of the patients, we observed a long segment of BE metaplasia (55.3% [95% CI: 51.7%-58.8%]). Different types of epithelial neoplasia were detected in 177 examined patients, which accounted for 23% of the total number of patients with BE. It was found that the greatest number of be changes were detected within a long segment of metaplasia (74.5% [95% CI: 68.1%-80.9%]). In less than 24% of cases [95% CI: 17.4%-30.0%], neoplasias were found within the short segment of BE. We identified a number of signs of low- and high-grade dysplasia, as well as non-invasive Barrett’s carcinoma.
About the Authors
V. I. Ryabtseva
P.A. Hertsen Moscow Ocology Research Institute - branch of the National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Russian Federation
S. S. Pirogov
P.A. Hertsen Moscow Ocology Research Institute - branch of the National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Russian Federation
D. G. Sukhin
P.A. Hertsen Moscow Ocology Research Institute - branch of the National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Russian Federation
N. N. Volchenko
P.A. Hertsen Moscow Ocology Research Institute - branch of the National Medical Research Radiological Centre of the Ministry of Health of Russia
Russian Federation
Russian Federation
References
1. Spechler S.J., Souza R.F. Barrett’s esophagus. N Engl J Med. 2014 Aug 28;371(9):836-45. doi: 10.1056/NEJMra1314704.
2. Jung K.W., Talley N.J., Romero Y. et аl. Epidemiology and natural history of intestinal metaplasia of the gastroesophageal junction and Barrett’s esophagus: a population-based study. Am J Gastroenterol. 2011 Aug;106(8):1447-55; quiz 1456. doi: 10.1038/ajg.2011.130.
3. Thota P.N., Vennalaganti P., Vennelaganti S. et аl. Low Risk of High-Grade Dysplasia or Esophageal Adenocarcinoma Among Patients With Barrett’s Esophagus Less Than 1 cm (Irregular Z Line) Within 5 Years of Index Endoscopy. Gastroenterology. 2017 Apr;152(5):987-992. doi: 10.1053/j.gastro.2016.12.005.
4. Cook M.B., Coburn S.B., Lam J.R. et аl. Cancer incidence and mortality risks in a large US Barrett’s oesophagus cohort. Gut. 2018 Mar;67(3):418-529. doi: 10.1136/gutjnl-2016-312223.
5. Huang J., Wang M., Li Z. et al. IDDF2024-ABS-0424 Global incidence of oesophageal cancer by histological and anatomical subtypes: a systematic analysis. Gut 2024;73: A378-A379 doi: 10.1136/gutjnl-2024-IDDF.337.
6. Pohl H., Welch H.G. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005 Jan 19;97(2):142-6. doi: 10.1093/jnci/dji024.
7. Beydoun A.S., Stabenau K.A., Altman K.W., Johnston N. Cancer Risk in Barrett’s Esophagus: A Clinical Review.Int J Mol Sci. 2023 Mar 23;24(7):6018. doi: 10.3390/ijms24076018.
8. Anaparthy R., Sharma P. Progression of Barrett oesophagus: role of endoscopic and histological predictors. Nat Rev Gastroenterol Hepatol. 2014 Sep;11(9):525-34. doi: 10.1038/nrgastro.2014.69.
9. Singh S., Manickam P., Amin A.V. et al. Incidence of esophageal adenocarcinoma in Barrett’s esophagus with low-grade dysplasia: a systematic review and meta-analysis. Gastrointest Endosc. 2014 Jun;79(6):897-909.e4; quiz 983.e1, 983.e3. doi: 10.1016/j.gie.2014.01.009.
10. Weusten B.L.A.M., Bisschops R., Dinis-Ribeiro M. et al. Diagnosis and management of Barrett esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2023 Dec;55(12):1124-1146. doi: 10.1055/a-2176-2440.
11. Rajendra S. Diagnosis and Management of Barrett’s Esophagus: An Updated ACG Guideline. Am J Gastroenterol. 2022 Nov 1;117(11):1880. doi: 10.14309/ajg.0000000000001896.
12. Rubenstein J.H., Sawas T., Wani S. et al. AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett’s Esophagus and Related Neoplasia. Gastroenterology. 2024 Jun;166(6):1020-1055. doi: 10.1053/j.gastro.2024.03.019.
13. Qumseya B., Sultan S., Bain P. et al. ASGE Standards of Practice Committee Chair. ASGE guideline on screening and surveillance of Barrett’s esophagus. Gastrointest Endosc. 2019 Sep;90(3):335-359.e2. doi: 10.1016/j.gie.2019.05.012.
14. Gupta N., Gaddam S., Wani S.B. et al. Longer inspection time is associated with increased detection of high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus. Gastrointest Endosc. 2012 Sep;76(3):531-8. doi: 10.1016/j.gie.2012.04.470.
15. Sharma P., Hawes R.H., Bansal A. et al. Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett’s oesophagus: a prospective, international, randomised controlled trial. Gut. 2013 Jan;62(1):15-21. doi: 10.1136/gutjnl-2011-300962.
16. de Groof A.J., Fockens K.N., Struyvenberg M.R. et al. Blue-light imaging and linked-color imaging improve visualization of Barrett’s neoplasia by nonexpert endoscopists. Gastrointest Endosc. 2020 May;91(5):1050-1057. doi: 10.1016/j.gie.2019.12.037.
17. Everson M.A., Lovat L.B., Graham D.G. et al. Virtual chromoendoscopy by using optical enhancement improves the detection of Barrett’s esophagus-associated neoplasia. Gastrointest Endosc. 2019 Feb;89(2):247-256.e4. doi: 10.1016/j.gie.2018.09.032.
18. Sharma P., Dent J., Armstrong D. et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria. Gastroenterology. 2006 Nov;131(5):1392-9. doi: 10.1053/j.gastro.2006.08.032.
19. Clermont M., Falk G.W. Clinical Guidelines Update on the Diagnosis and Management of Barrett’s Esophagus. Dig Dis Sci. 2018 Aug;63(8):2122-2128. doi: 10.1007/s10620-018-5070-z.
20. Hamade N., Vennelaganti S., Parasa S. et al. Lower Annual Rate of Progression of Short-Segment vs Long-Segment Barrett’s Esophagus to Esophageal Adenocarcinoma. Clin Gastroenterol Hepatol. 2019 Apr;17(5):864-868. doi: 10.1016/j.cgh.2018.07.008.
21. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003 Dec;58(6 Suppl): S3-43. doi: 10.1016/s0016-5107(03)02159-x.
22. Sharma P., Bergman J.J., Goda K. et al. Development and Validation of a Classification System to Identify High-Grade Dysplasia and Esophageal Adenocarcinoma in Barrett’s Esophagus Using Narrow-Band Imaging. Gastroenterology. 2016 Mar;150(3):591-8. doi: 10.1053/j.gastro.2015.11.037.
23. Goda K., Takeuchi M., Ishihara R. et al. Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett’s esophagus-related neoplasms: a nationwide multicenter study. Esophagus. 2021 Oct;18(4):713-723. doi: 10.1007/s10388-021-00841-1.
24. He T., Iyer K.G., Lai M. et al. Endoscopic features of low-grade dysplastic Barrett’s. Endosc Int Open. 2023 Aug 7;11(8): E736-E742. doi: 10.1055/a-2102-7726.
25. Tsoi E.H., Fehily S., Williams R. et al. Diffuse endoscopically visible, predominantly low-grade dysplasia in Barrett’s esophagus (with video). Endosc Int Open. 2019 Dec;7(12): E1742-E1747. doi: 10.1055/a-1031-9327.
26. van der Wel M.J., Coleman H.G., Bergman J.J.G.H.M. et al. BOLERO working group. Histopathologist features predictive of diagnostic concordance at expert level among a large international sample of pathologists diagnosing Barrett’s dysplasia using digital pathology. Gut. 2020 May;69(5):811-822. doi: 10.1136/gutjnl-2019-318985.
27. Yoshida N., Doyama H., Nakanishi H. et al. White globe appearance is a novel specific endoscopic marker for gastric cancer: A prospective study. Dig Endosc. 2016 Jan;28(1):59-66. doi: 10.1111/den.12519.
28. Kubota Y., Tanabe S., Harada Y. et al. Barrett’s Esophageal Adenocarcinoma Involving a White Globe Appearance within the Long-Segment Barrett’s Esophagus. Case Rep Gastroenterol. 2020 Oct 22;14(3):510-515. doi: 10.1159/ 000508861.
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For citations:
Ryabtseva V.I., Pirogov S.S., Sukhin D.G., Volchenko N.N. Neoplasia of Barrett’s esophagus: modern concepts of endoscopic diagnostics and experience of the P.A. Herzen Moscow Oncology Research Institute. Experimental and Clinical Gastroenterology. 2025;(5):18-23. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-237-5-18-23
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