Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study
Background Immune imbalance and inflammation have been suggested as key factors of Barrett’s esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant condition...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2020, Vol.24 (1), p.8-18 |
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| creator | Campos, Vinicius J. Mazzini, Guilherme S. Juchem, José F. Gurski, Richard R. |
| description | Background
Immune imbalance and inflammation have been suggested as key factors of Barrett’s esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia.
Methods
We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (
n
= 113) were classified as non-dysplastic BE (NDBE,
n
= 72), dysplastic BE (DBE,
n
= 11) and EAC (
n
= 30).
Results
NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (
r
= 0.53,
p
2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8).
Conclusion
NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies. |
| doi_str_mv | 10.1007/s11605-019-04456-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_31745889</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2347102220</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c2ce946c4cbbf4d81314c968a72708dea2a72d99612d9bb41dcc309810e3744b3</originalsourceid><addsrcrecordid>eNqNkc1u1TAQhSNERUvhBVggSyyRy9hx_ti1ofxIl4JakNhFjjO5TbmJg8eBZtfXYM-T8ST1JW3ZITb2jPSd42OdKHoi4EAAZC9IiBQSDqLgoFSS8st70Z7Is5irVKb3wwyF4DJJvuxGD4kuAEQGIn8Q7cYiU0meF3vRrxOcvLPjebfhq7kfz62ZPbJT7TvLNDHN3mv3FR2zLfvo7NohUWcH1jrbsxM78FczjRtNvjPsSDuH3v---knsmIKnXk_EvL1dUG_YYYODNdqZbrC9fhn8S2eJ-Bma8OIQiFMMeWjc7t-RnfmpmR9FO63eED6-ufejz6-PP5Vv-erDm3fl4YqbOEs8N9JgoVKjTF23qslFLJQp0lxnMoO8QS3D1BRFKsJZ10o0xsRQ5AIwzpSq4_3o2eI7OvttQvLVhZ1cCEWVjFUmQEoJgZILZbbJHbbV6Lpeu7kSUG2LqZZiqlBM9aeY6jKInt5YT3WPzZ3ktokA5AvwA2vbkulwMHiHAUAiIbgWYQJZdn5b0FDaafBB-vz_pYGOF5oCMazR_f3kP_JfA_1XvnI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2347102220</pqid></control><display><type>article</type><title>Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Campos, Vinicius J. ; Mazzini, Guilherme S. ; Juchem, José F. ; Gurski, Richard R.</creator><creatorcontrib>Campos, Vinicius J. ; Mazzini, Guilherme S. ; Juchem, José F. ; Gurski, Richard R.</creatorcontrib><description>Background
Immune imbalance and inflammation have been suggested as key factors of Barrett’s esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia.
Methods
We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (
n
= 113) were classified as non-dysplastic BE (NDBE,
n
= 72), dysplastic BE (DBE,
n
= 11) and EAC (
n
= 30).
Results
NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (
r
= 0.53,
p
< 0.001). NLR > 2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8).
Conclusion
NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-019-04456-x</identifier><identifier>PMID: 31745889</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>2019 SSAT Plenary Presentation ; Adenocarcinoma - blood ; Adenocarcinoma - etiology ; Adenocarcinoma - pathology ; Barrett Esophagus - blood ; Barrett Esophagus - complications ; Barrett Esophagus - pathology ; Cross-Sectional Studies ; Disease Progression ; Esophageal cancer ; Esophageal Neoplasms - blood ; Esophageal Neoplasms - etiology ; Esophageal Neoplasms - pathology ; Esophagus ; Female ; Gastroenterology ; Gastroenterology & Hepatology ; Health risk assessment ; Humans ; Hyperplasia ; Life Sciences & Biomedicine ; Lymphocyte Count ; Lymphocytes ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neutrophils ; Retrospective Studies ; Science & Technology ; Sensitivity and Specificity ; Surgery</subject><ispartof>Journal of gastrointestinal surgery, 2020, Vol.24 (1), p.8-18</ispartof><rights>The Society for Surgery of the Alimentary Tract 2019</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>10</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000520160900002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c375t-c2ce946c4cbbf4d81314c968a72708dea2a72d99612d9bb41dcc309810e3744b3</citedby><cites>FETCH-LOGICAL-c375t-c2ce946c4cbbf4d81314c968a72708dea2a72d99612d9bb41dcc309810e3744b3</cites><orcidid>0000-0003-2115-0932</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-019-04456-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-019-04456-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31745889$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Campos, Vinicius J.</creatorcontrib><creatorcontrib>Mazzini, Guilherme S.</creatorcontrib><creatorcontrib>Juchem, José F.</creatorcontrib><creatorcontrib>Gurski, Richard R.</creatorcontrib><title>Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J GASTROINTEST SURG</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Immune imbalance and inflammation have been suggested as key factors of Barrett’s esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia.
Methods
We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (
n
= 113) were classified as non-dysplastic BE (NDBE,
n
= 72), dysplastic BE (DBE,
n
= 11) and EAC (
n
= 30).
Results
NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (
r
= 0.53,
p
< 0.001). NLR > 2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8).
Conclusion
NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.</description><subject>2019 SSAT Plenary Presentation</subject><subject>Adenocarcinoma - blood</subject><subject>Adenocarcinoma - etiology</subject><subject>Adenocarcinoma - pathology</subject><subject>Barrett Esophagus - blood</subject><subject>Barrett Esophagus - complications</subject><subject>Barrett Esophagus - pathology</subject><subject>Cross-Sectional Studies</subject><subject>Disease Progression</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - blood</subject><subject>Esophageal Neoplasms - etiology</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroenterology & Hepatology</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Life Sciences & Biomedicine</subject><subject>Lymphocyte Count</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neutrophils</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Sensitivity and Specificity</subject><subject>Surgery</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1u1TAQhSNERUvhBVggSyyRy9hx_ti1ofxIl4JakNhFjjO5TbmJg8eBZtfXYM-T8ST1JW3ZITb2jPSd42OdKHoi4EAAZC9IiBQSDqLgoFSS8st70Z7Is5irVKb3wwyF4DJJvuxGD4kuAEQGIn8Q7cYiU0meF3vRrxOcvLPjebfhq7kfz62ZPbJT7TvLNDHN3mv3FR2zLfvo7NohUWcH1jrbsxM78FczjRtNvjPsSDuH3v---knsmIKnXk_EvL1dUG_YYYODNdqZbrC9fhn8S2eJ-Bma8OIQiFMMeWjc7t-RnfmpmR9FO63eED6-ufejz6-PP5Vv-erDm3fl4YqbOEs8N9JgoVKjTF23qslFLJQp0lxnMoO8QS3D1BRFKsJZ10o0xsRQ5AIwzpSq4_3o2eI7OvttQvLVhZ1cCEWVjFUmQEoJgZILZbbJHbbV6Lpeu7kSUG2LqZZiqlBM9aeY6jKInt5YT3WPzZ3ktokA5AvwA2vbkulwMHiHAUAiIbgWYQJZdn5b0FDaafBB-vz_pYGOF5oCMazR_f3kP_JfA_1XvnI</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Campos, Vinicius J.</creator><creator>Mazzini, Guilherme S.</creator><creator>Juchem, José F.</creator><creator>Gurski, Richard R.</creator><general>Springer US</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>95M</scope><scope>ABMOY</scope><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><orcidid>https://orcid.org/0000-0003-2115-0932</orcidid></search><sort><creationdate>2020</creationdate><title>Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study</title><author>Campos, Vinicius J. ; Mazzini, Guilherme S. ; Juchem, José F. ; Gurski, Richard R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c2ce946c4cbbf4d81314c968a72708dea2a72d99612d9bb41dcc309810e3744b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>2019 SSAT Plenary Presentation</topic><topic>Adenocarcinoma - blood</topic><topic>Adenocarcinoma - etiology</topic><topic>Adenocarcinoma - pathology</topic><topic>Barrett Esophagus - blood</topic><topic>Barrett Esophagus - complications</topic><topic>Barrett Esophagus - pathology</topic><topic>Cross-Sectional Studies</topic><topic>Disease Progression</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - blood</topic><topic>Esophageal Neoplasms - etiology</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroenterology & Hepatology</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Life Sciences & Biomedicine</topic><topic>Lymphocyte Count</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neutrophils</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Sensitivity and Specificity</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Campos, Vinicius J.</creatorcontrib><creatorcontrib>Mazzini, Guilherme S.</creatorcontrib><creatorcontrib>Juchem, José F.</creatorcontrib><creatorcontrib>Gurski, Richard R.</creatorcontrib><collection>Conference Proceedings Citation Index - Science (CPCI-S)</collection><collection>Conference Proceedings Citation Index - Science (CPCI-S) 2020</collection><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Campos, Vinicius J.</au><au>Mazzini, Guilherme S.</au><au>Juchem, José F.</au><au>Gurski, Richard R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><stitle>J GASTROINTEST SURG</stitle><addtitle>J Gastrointest Surg</addtitle><date>2020</date><risdate>2020</risdate><volume>24</volume><issue>1</issue><spage>8</spage><epage>18</epage><pages>8-18</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Immune imbalance and inflammation have been suggested as key factors of Barrett’s esophagus (BE) pathway towards adenocarcinoma. The neutrophil-lymphocyte ratio (NLR) indirectly reflects the relation between innate and adaptive immune systems and has been studied in premalignant conditions as a biomarker for cancer diagnosis. Our aim was to investigate if increasing values of NLR correlated with advancing stages of BE progression to dysplasia and neoplasia.
Methods
We retrospectively analyzed data of patients with biopsies reporting BE between 2013 and 2017 and with a complete blood count within 6 months from the endoscopy, as well as patients with esophageal adenocarcinoma (EAC). NLR was calculated as neutrophil count/lymphocyte count. Cases (
n
= 113) were classified as non-dysplastic BE (NDBE,
n
= 72), dysplastic BE (DBE,
n
= 11) and EAC (
n
= 30).
Results
NLR progressively increased across groups (NDBE, 1.92 ± 0.7; DBE, 2.92 ± 1.1; EAC 4.54 ± 2.9), with a significant correlation between its increasing value and the presence of dysplasia or neoplasia (
r
= 0.53,
p
< 0.001). NLR > 2.27 was able to diagnose EAC with 80% sensitivity and 71% specificity (area under the curve = 0.8).
Conclusion
NLR correlates with advancing stages of BE progression, a finding that reinforces the role of immune imbalance in EAC carcinogenesis and suggests a possible use of this marker for risk stratification on surveillance strategies.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31745889</pmid><doi>10.1007/s11605-019-04456-x</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2115-0932</orcidid></addata></record> |
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| ispartof | Journal of gastrointestinal surgery, 2020, Vol.24 (1), p.8-18 |
| issn | 1091-255X 1873-4626 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | 2019 SSAT Plenary Presentation Adenocarcinoma - blood Adenocarcinoma - etiology Adenocarcinoma - pathology Barrett Esophagus - blood Barrett Esophagus - complications Barrett Esophagus - pathology Cross-Sectional Studies Disease Progression Esophageal cancer Esophageal Neoplasms - blood Esophageal Neoplasms - etiology Esophageal Neoplasms - pathology Esophagus Female Gastroenterology Gastroenterology & Hepatology Health risk assessment Humans Hyperplasia Life Sciences & Biomedicine Lymphocyte Count Lymphocytes Male Medicine Medicine & Public Health Middle Aged Neutrophils Retrospective Studies Science & Technology Sensitivity and Specificity Surgery |
| title | Neutrophil-Lymphocyte Ratio as a Marker of Progression from Non-Dysplastic Barrett’s Esophagus to Esophageal Adenocarcinoma: a Cross-Sectional Retrospective Study |
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