1. Conventional White Light Endoscopic Features of Small Superficial Barrett's Esophageal Adenocarcinoma
- Author
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Yasutaka Kuribayashi, Shu Hoteya, Kosuke Nomura, Takahito Toba, Mitsuru Kaise, Akhiro Yamada, Toshiro Iizuka, Satoshi Yamashita, Osamu Ogawa, Takumi Tanaka, Toshifumi Mitani, Daisuke Kikuchi, Tsukasa Furuhata, and Akira Matsui
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Esophageal Neoplasms ,Tumor burden ,Esophageal adenocarcinoma ,Adenocarcinoma ,digestive system ,Cohort Studies ,Lesion ,Barrett Esophagus ,03 medical and health sciences ,0302 clinical medicine ,Gastroscopy ,medicine ,White light ,Humans ,Neoplasm Invasiveness ,Esophagus ,neoplasms ,Aged ,Retrospective Studies ,Mucous Membrane ,integumentary system ,business.industry ,Dissection ,Gastroenterology ,Middle Aged ,digestive system diseases ,Tumor Burden ,Hernia, Hiatal ,surgical procedures, operative ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Esophagogastric Junction ,Esophagoscopy ,medicine.symptom ,business - Abstract
Background: Superficial Barrett's esophageal adenocarcinoma (BEA) arising from short-segment Barrett's esophagus (SSBE) is visualized as a reddish lesion located on the right or anterior side wall of the esophagogastric mucosal junction (EGJ) and showing an elevated macroscopic appearance under conventional white light endoscopy (WLE). However, because the form and color are variable, misdiagnosis as reflux esophagitis or SSBE is frequent under WLE. The aim of this study is to clarify conventional WLE features of small superficial BEA. Summary: We retrospectively analyzed 30 lesions ≤20 mm in diameter in 30 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at Toranomon Hospital between 2002 and 2014. Mean age of patients with small superficial BEA arising from SSBE was 64.3 ± 11.2 years, and mean tumor size was 12.0 ± 4.8 mm. Small superficial BEA fell into the following 4 categories based on WLE features: EGJ polyp type, 43.3% (13 of 30 lesions); triangular SSBE type, 43.3% (13 of 30 lesions); cardiac erosion type, 10.0% (3 of 30 lesions); and unclassified or mixed type, 3.4% (1 of 30 lesions). EGJ polyp-type tumors were located on the right or anterior side wall of the EGJ, and no tumors showed invasion to the submucosal layer. On the other hand, triangular SSBE-type tumors were located anywhere in the EGJ, and 38.5% showed submucosal invasion (5 of 13 lesions). Key Messages: We consider this classification significantly contributes to the detection of small superficial BEA arising from SSBE under WLE.
- Published
- 2016
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