Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia
Background: Unsedated transnasal upper endoscopy has a diagnostic yield comparable with that of sedated conventional upper endoscopy. The ability of transnasal upper endoscopy to detect Barrett's metaplasia or dysplastic change has not been systematically evaluated. The aim of this study was to...
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| Veröffentlicht in: | Gastrointestinal endoscopy 2002-10, Vol.56 (4), p.472-478 |
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| container_title | Gastrointestinal endoscopy |
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| creator | Saeian, Kia Staff, David M. Vasilopoulos, Sotirios Townsend, William F. Almagro, Urias A. Komorowski, Richard A. Choi, Hongyung Shaker, Reza |
| description | Background: Unsedated transnasal upper endoscopy has a diagnostic yield comparable with that of sedated conventional upper endoscopy. The ability of transnasal upper endoscopy to detect Barrett's metaplasia or dysplastic change has not been systematically evaluated. The aim of this study was to assess the feasibility of transnasal upper endoscopy for surveillance of patients with Barrett's esophagus and to evaluate its histopathologic yield for Barrett's metaplasia and dysplasia.
Methods: Thirty-two patients with Barrett's esophagus were evaluated with conventional upper endoscopy and transnasal upper endoscopy. An effort was made to recruit patients known to have dysplasia. Quadrantic biopsy specimens were taken with standard (conventional upper endoscopy) and pediatric (transnasal upper endoscopy) biopsy forceps at procedures performed at least 1 week apart. Two blinded pathologists evaluated the specimens.
Results: Transnasal upper endoscopy detected Barrett's metaplasia histopathologically in 31 of 32 patients. Level of agreement for presence of dysplasia in biopsy specimens obtained between conventional upper endoscopy and transnasal upper endoscopy was excellent (k = 0.79). Interobserver agreement for dysplasia in specimens obtained by conventional upper endoscopy (k = 0.61) and by transnasal upper endoscopy (k = 0.61) were similar. Intraobserver agreement between conventional upper endoscopy and transnasal upper endoscopy biopsy specimens for dysplasia by pathologist 1 (k = 0.73) and pathologist 2 (k = 0.75) were also similar. No significant adverse effects were noted.
Conclusions: Transnasal upper endoscopy is feasible and accurate for identification and histopathologic confirmation of Barrett's metaplasia with a histopathologic yield for dysplasia comparable with conventional upper endoscopy. (Gastrointest Endosc 2002;56:472-8.) |
| doi_str_mv | 10.1016/S0016-5107(02)70429-X |
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Methods: Thirty-two patients with Barrett's esophagus were evaluated with conventional upper endoscopy and transnasal upper endoscopy. An effort was made to recruit patients known to have dysplasia. Quadrantic biopsy specimens were taken with standard (conventional upper endoscopy) and pediatric (transnasal upper endoscopy) biopsy forceps at procedures performed at least 1 week apart. Two blinded pathologists evaluated the specimens.
Results: Transnasal upper endoscopy detected Barrett's metaplasia histopathologically in 31 of 32 patients. Level of agreement for presence of dysplasia in biopsy specimens obtained between conventional upper endoscopy and transnasal upper endoscopy was excellent (k = 0.79). Interobserver agreement for dysplasia in specimens obtained by conventional upper endoscopy (k = 0.61) and by transnasal upper endoscopy (k = 0.61) were similar. Intraobserver agreement between conventional upper endoscopy and transnasal upper endoscopy biopsy specimens for dysplasia by pathologist 1 (k = 0.73) and pathologist 2 (k = 0.75) were also similar. No significant adverse effects were noted.
Conclusions: Transnasal upper endoscopy is feasible and accurate for identification and histopathologic confirmation of Barrett's metaplasia with a histopathologic yield for dysplasia comparable with conventional upper endoscopy. (Gastrointest Endosc 2002;56:472-8.)</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/S0016-5107(02)70429-X</identifier><identifier>PMID: 12297760</identifier><identifier>CODEN: GAENBQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Barrett Esophagus - pathology ; Biological and medical sciences ; Biopsy - instrumentation ; Biopsy - methods ; Digestive system. Abdomen ; Endoscopy ; Esophageal Neoplasms - pathology ; Esophagogastric Junction - pathology ; Esophagoscopes ; Esophagoscopy - methods ; Feasibility Studies ; Female ; Humans ; Hypnotics and Sedatives - administration & dosage ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Metaplasia - pathology ; Middle Aged ; Precancerous Conditions - pathology ; Reproducibility of Results ; Sensitivity and Specificity</subject><ispartof>Gastrointestinal endoscopy, 2002-10, Vol.56 (4), p.472-478</ispartof><rights>2002 American Society for Gastrointestinal Endoscopy</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c306t-54ba90454de4613a5e1b0ce736583d34b49e4aef294bcdfdc807f96c79eea87b3</citedby><cites>FETCH-LOGICAL-c306t-54ba90454de4613a5e1b0ce736583d34b49e4aef294bcdfdc807f96c79eea87b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S001651070270429X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13959377$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12297760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saeian, Kia</creatorcontrib><creatorcontrib>Staff, David M.</creatorcontrib><creatorcontrib>Vasilopoulos, Sotirios</creatorcontrib><creatorcontrib>Townsend, William F.</creatorcontrib><creatorcontrib>Almagro, Urias A.</creatorcontrib><creatorcontrib>Komorowski, Richard A.</creatorcontrib><creatorcontrib>Choi, Hongyung</creatorcontrib><creatorcontrib>Shaker, Reza</creatorcontrib><title>Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Background: Unsedated transnasal upper endoscopy has a diagnostic yield comparable with that of sedated conventional upper endoscopy. The ability of transnasal upper endoscopy to detect Barrett's metaplasia or dysplastic change has not been systematically evaluated. The aim of this study was to assess the feasibility of transnasal upper endoscopy for surveillance of patients with Barrett's esophagus and to evaluate its histopathologic yield for Barrett's metaplasia and dysplasia.
Methods: Thirty-two patients with Barrett's esophagus were evaluated with conventional upper endoscopy and transnasal upper endoscopy. An effort was made to recruit patients known to have dysplasia. Quadrantic biopsy specimens were taken with standard (conventional upper endoscopy) and pediatric (transnasal upper endoscopy) biopsy forceps at procedures performed at least 1 week apart. Two blinded pathologists evaluated the specimens.
Results: Transnasal upper endoscopy detected Barrett's metaplasia histopathologically in 31 of 32 patients. Level of agreement for presence of dysplasia in biopsy specimens obtained between conventional upper endoscopy and transnasal upper endoscopy was excellent (k = 0.79). Interobserver agreement for dysplasia in specimens obtained by conventional upper endoscopy (k = 0.61) and by transnasal upper endoscopy (k = 0.61) were similar. Intraobserver agreement between conventional upper endoscopy and transnasal upper endoscopy biopsy specimens for dysplasia by pathologist 1 (k = 0.73) and pathologist 2 (k = 0.75) were also similar. No significant adverse effects were noted.
Conclusions: Transnasal upper endoscopy is feasible and accurate for identification and histopathologic confirmation of Barrett's metaplasia with a histopathologic yield for dysplasia comparable with conventional upper endoscopy. (Gastrointest Endosc 2002;56:472-8.)</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Barrett Esophagus - pathology</subject><subject>Biological and medical sciences</subject><subject>Biopsy - instrumentation</subject><subject>Biopsy - methods</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophagogastric Junction - pathology</subject><subject>Esophagoscopes</subject><subject>Esophagoscopy - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - administration & dosage</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metaplasia - pathology</subject><subject>Middle Aged</subject><subject>Precancerous Conditions - pathology</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1P3DAQQK0KVBbKTwDlUmgPKePYieMTAlSgElIPBYmbNbEnUqpssvV4K-2_r2FX5chlRqN586EnxImEbxJkc_ELcixrCeYLVF8N6MqWzx_EQoI1ZWOM3ROL_8iBOGT-DQBtpeRHcSCryhrTwEI8Pk1MAROFIkWceELGsaApzOzn1aZA79cxt8dNESiRT1xcY4yU0jkXS0q4GpEHLHAKRdjwtvok9nscmY53-Ug83X5_vLkvH37e_bi5eii9giaVte7Qgq51IN1IhTXJDjwZ1dStCkp32pJG6iurOx_64FswvW28sUTYmk4dibPt3lWc_6yJk1sO7GkccaJ5zc5UUrYtyAzWW9DHmTlS71ZxWGLcOAnuRad71eleXDmo3KtO95znTncH1t2SwtvUzl8GPu8AZI9jnxX6gd84ZWurjMnc5ZajrOPvQNGxH2jyFIaYpbowD--88g8HwpNd</recordid><startdate>200210</startdate><enddate>200210</enddate><creator>Saeian, Kia</creator><creator>Staff, David M.</creator><creator>Vasilopoulos, Sotirios</creator><creator>Townsend, William F.</creator><creator>Almagro, Urias A.</creator><creator>Komorowski, Richard A.</creator><creator>Choi, Hongyung</creator><creator>Shaker, Reza</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200210</creationdate><title>Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia</title><author>Saeian, Kia ; Staff, David M. ; Vasilopoulos, Sotirios ; Townsend, William F. ; Almagro, Urias A. ; Komorowski, Richard A. ; Choi, Hongyung ; Shaker, Reza</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-54ba90454de4613a5e1b0ce736583d34b49e4aef294bcdfdc807f96c79eea87b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Barrett Esophagus - pathology</topic><topic>Biological and medical sciences</topic><topic>Biopsy - instrumentation</topic><topic>Biopsy - methods</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophagogastric Junction - pathology</topic><topic>Esophagoscopes</topic><topic>Esophagoscopy - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - administration & dosage</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metaplasia - pathology</topic><topic>Middle Aged</topic><topic>Precancerous Conditions - pathology</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saeian, Kia</creatorcontrib><creatorcontrib>Staff, David M.</creatorcontrib><creatorcontrib>Vasilopoulos, Sotirios</creatorcontrib><creatorcontrib>Townsend, William F.</creatorcontrib><creatorcontrib>Almagro, Urias A.</creatorcontrib><creatorcontrib>Komorowski, Richard A.</creatorcontrib><creatorcontrib>Choi, Hongyung</creatorcontrib><creatorcontrib>Shaker, Reza</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saeian, Kia</au><au>Staff, David M.</au><au>Vasilopoulos, Sotirios</au><au>Townsend, William F.</au><au>Almagro, Urias A.</au><au>Komorowski, Richard A.</au><au>Choi, Hongyung</au><au>Shaker, Reza</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2002-10</date><risdate>2002</risdate><volume>56</volume><issue>4</issue><spage>472</spage><epage>478</epage><pages>472-478</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><coden>GAENBQ</coden><abstract>Background: Unsedated transnasal upper endoscopy has a diagnostic yield comparable with that of sedated conventional upper endoscopy. The ability of transnasal upper endoscopy to detect Barrett's metaplasia or dysplastic change has not been systematically evaluated. The aim of this study was to assess the feasibility of transnasal upper endoscopy for surveillance of patients with Barrett's esophagus and to evaluate its histopathologic yield for Barrett's metaplasia and dysplasia.
Methods: Thirty-two patients with Barrett's esophagus were evaluated with conventional upper endoscopy and transnasal upper endoscopy. An effort was made to recruit patients known to have dysplasia. Quadrantic biopsy specimens were taken with standard (conventional upper endoscopy) and pediatric (transnasal upper endoscopy) biopsy forceps at procedures performed at least 1 week apart. Two blinded pathologists evaluated the specimens.
Results: Transnasal upper endoscopy detected Barrett's metaplasia histopathologically in 31 of 32 patients. Level of agreement for presence of dysplasia in biopsy specimens obtained between conventional upper endoscopy and transnasal upper endoscopy was excellent (k = 0.79). Interobserver agreement for dysplasia in specimens obtained by conventional upper endoscopy (k = 0.61) and by transnasal upper endoscopy (k = 0.61) were similar. Intraobserver agreement between conventional upper endoscopy and transnasal upper endoscopy biopsy specimens for dysplasia by pathologist 1 (k = 0.73) and pathologist 2 (k = 0.75) were also similar. No significant adverse effects were noted.
Conclusions: Transnasal upper endoscopy is feasible and accurate for identification and histopathologic confirmation of Barrett's metaplasia with a histopathologic yield for dysplasia comparable with conventional upper endoscopy. (Gastrointest Endosc 2002;56:472-8.)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>12297760</pmid><doi>10.1016/S0016-5107(02)70429-X</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Barrett Esophagus - pathology Biological and medical sciences Biopsy - instrumentation Biopsy - methods Digestive system. Abdomen Endoscopy Esophageal Neoplasms - pathology Esophagogastric Junction - pathology Esophagoscopes Esophagoscopy - methods Feasibility Studies Female Humans Hypnotics and Sedatives - administration & dosage Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Metaplasia - pathology Middle Aged Precancerous Conditions - pathology Reproducibility of Results Sensitivity and Specificity |
| title | Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia |
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