P.1.246: PROGRESSION OF CATEGORY 3 OF VIENNA GASTRIC NEOPLASIA CLASSIFICATION [LOW-GRADE-DYSPLASIA (LGD)]: A 50-MONTHS FOLLOW-UP AND ROLE OF ENDOSCOPIC MUCOSAL RESECTION (EMR)

2011 ◽  
Vol 43 ◽  
pp. S229-S230
Author(s):  
R. Suriani ◽  
S. Grosso ◽  
G. Valentini ◽  
A. Vernetto ◽  
A.M. Serra ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Low Grade ◽  
Mucosal Resection ◽  
Gastric Neoplasia ◽  
Low Grade Dysplasia

Gastric Low-Grade Dysplasia: Follow-Up and Role of Endoscopic Mucosal Resection

2007 ◽  
Vol 65 (5) ◽  
pp. AB166
Author(s):  
Renzo Suriani ◽  
Valerio Marci ◽  
Dario Mazzucco ◽  
Ivo Venturini ◽  
Silvia Grosso ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Low Grade ◽  
Mucosal Resection ◽  
Low Grade Dysplasia

scholarly journals Endoscopic Mucosal Resection: Early Experience in British Columbia

2010 ◽  
Vol 24 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Mayur Brahmania ◽  
Eric Lam ◽  
Jennifer Telford ◽  
Robert Enns
Keyword(s):  
British Columbia ◽  
Barrett’S Esophagus ◽  
Endoscopic Mucosal Resection ◽  
Barrett's Esophagus ◽  
Low Grade ◽  
Complication Rates ◽  
The Third ◽  
Mucosal Resection ◽  
The Mean

BACKGROUND: Endoscopic mucosal resection (EMR) has been proposed as a primary method of managing patients with dysplasia- or mucosal-based cancers of the esophagus.OBJECTIVES: To evaluate the use of EMR for the treatment of Barrett’s esophagus with dysplasia or early adenocarcinoma, assessing efficacy, complication rates and long-term outcomes.METHODS: All patients who underwent EMR at St Paul’s Hospital (Vancouver, British Columbia) were reviewed. Eligible patients were assessed with aggressive biopsy protocols. Detected cancers were staged with both endoscopic ultrasound imaging and computed tomography. Appropriate patients were offered EMR using a commercially available mucosectomy device. EMR was repeated at six- to eight-week intervals until complete. Patients with less than one year of follow-up or who were undergoing other ablative methods were excluded.RESULTS: Twenty-two patients (all men) with a mean (± SD) age of 67±10.6 years were identified. The mean duration of gastroesophageal reflux disease was 17 years (range four to 40 years) and all were receiving proton pump inhibitor therapy. The mean length of Barrett’s esophagus was 5.5±3.5 cm. One patient had no dysplasia (isolated nodule), three had low-grade dysplasia, 15 had high-grade dysplasia (HGD) and three had adenocarcinoma. A mean of 1.7±0.83 endoscopic sessions were performed, with a mean of 6±5.4 sections removed. Following EMR, three patients developed strictures; two of these patients had pre-existing strictures and the third required two dilations, which resolved his symptoms. There were no other complications. Three patients underwent esophagectomy. Two had adenocarcinoma or HGD in a pre-existing stricture. The third patient had an adenocarcinoma not amenable to EMR. One patient with a long segment of Barrett’s esophagus underwent radiofrequency ablation. At a median follow-up of two years (range one to three years), the remaining 18 patients (82%) had no evidence of HGD or cancer.CONCLUSION: Most patients with esophageal dysplasia can be managed with EMR. Individuals with pre-existing strictures require other endoscopic and/or surgical methods to manage their dysplasia or adenocarcinoma.

Diagnostic Value of Endoscopic Mucosal Resection in Low Grade Dysplasia of Gastric Mucosa

2006 ◽  
Vol 63 (5) ◽  
pp. AB105
Author(s):  
Byoung Kuk Jang ◽  
Yeong Seok Lee ◽  
Seong Yeol Kim ◽  
Hong Sug Lee ◽  
Woo Jin Chung ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Endoscopic Mucosal Resection ◽  
Diagnostic Value ◽  
Low Grade ◽  
Mucosal Resection ◽  
Low Grade Dysplasia

scholarly journals Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett’s Esophagus and Related Superficial Lesions

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hany M. Elsadek ◽  
Mamdouh M. Radwan
Keyword(s):  
Barrett’S Esophagus ◽  
Endoscopic Mucosal Resection ◽  
Barrett's Esophagus ◽  
Endoscopic Examination ◽  
Low Grade ◽  
Invasive Adenocarcinoma ◽  
Mucosal Resection ◽  
Routine Surveillance ◽  
Histopathologic Diagnosis

Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49.75±13.3 years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results. Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa =0.43, 95% CI: 0.170–0.69). Conclusions. Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients.

The predictive value of p53, MDM-2, cyclin D1 and Ki67 in the progression from low-grade dysplasia towards carcinoma of the larynx

1998 ◽  
Vol 112 (5) ◽  
pp. 455-459 ◽  
Author(s):  
Lorenzo Pignataro ◽  
Pasquale Capaccio ◽  
Giancarlo Pruneri ◽  
Nadia Carboni ◽  
Roberto Buffa ◽  
...  
Keyword(s):  
Cyclin D1 ◽  
Low Grade ◽  
Ki67 Expression ◽  
Laryngeal Mucosa ◽  
Carcinoma Of The Larynx ◽  
Immunohistochemical Assessment ◽  
Predictive Role ◽  
Low Grade Dysplasia

AbstractTo evaluate the predictive role of the oncogenes p53, MDM-2 and cyclin D1, and the proliferative marker Ki67, in the progression from low-grade dysplasia to carcinoma of the larynx. We studied immunohistochemically a series of 32 low-grade pre-neoplastic laryngeal lesions, 10 of which progressed to invasive carcinoma. Immunoreactivity in more than 10 per cent of the dysplastic cells was detected in five cases immunostained with anti-p53 (≈ 15 per cent), in two with anti-MDM-2 (≈ six per cent), and 11 with anti-Ki67 antibodies (≈ 34 per cent), whereas none of the cases showed cyclin D1 overexpression. No significant association was found between p53 and MDM-2 immunoreactivity and the evolution to carcinoma; on the contrary, Ki67 expression was detectable in all but one of the 10 cases developing an infiltrative tumour (90 per cent), and in two of the 22 cases that did not progress (≈ nine per cent) (p = 0.01). These findings indicate that immunohistochemical assessment of the proliferative index in bioptic samples of dysplastic laryngeal mucosa may be useful in selecting patients who should undergo a more specific follow-up evaluation.

Endoscopic Therapy for Dysplastic Barrett Esophagus and Intramucosal Cancer

2018 ◽  
Author(s):  
Aymeric Becq ◽  
Tyler M Berzin
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Endoscopic Therapy ◽  
Barrett Esophagus ◽  
Low Grade ◽  
High Grade ◽  
First Line ◽  
Mucosal Resection ◽  
First Line Therapy ◽  
Line Therapy ◽  
Low Grade Dysplasia

Barrett esophagus (BE) is a common premalignant condition that may evolve from nondysplastic intestinal metaplasia to low-grade dysplasia (LGD), high-grade dysplasia (HGD), and ultimately to esophageal adenocarcinoma (EAC). This review addresses the range of endoscopic approaches for treating dysplastic BE and early EAC. Endoscopic treatment is favored for most patients with LGD, although endoscopic surveillance continues to be an alternative. Endoscopic eradication is definitively recommended for patients with HGD. Radiofrequency ablation is the preferred technique for ablation of dysplastic BE, although there is also strong support for endoscopic mucosal resection as a first-line therapy. Cryotherapy is emerging as a valid alternative ablative approach. Endoscopic resection by endoscopic mucosal resection or endoscopic submucosal dissection is recommended as the first-line therapy for nodular BE and T1a EAC. Post-eradication endoscopic surveillance is indicated at intervals that depend on the category of pretreatment dysplasia. Because of advances in endoscopic therapy, surgery is now indicated only when endoscopic ablation or resection has failed or in the setting of more advanced EAC. This review contains 8 figures, 2 tables, and 55 references. Key Words: cryotherapy, endoscopic mucosal resection, esophageal adenocarcinoma, esophagectomy, high-grade dysplasia, low-grade dysplasia, nodular Barrett esophagus, radiofrequency ablation

Endoscopic Therapy for Dysplastic Barrett Esophagus and Intramucosal Cancer

2018 ◽  
Author(s):  
Aymeric Becq ◽  
Tyler M Berzin
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Endoscopic Therapy ◽  
Barrett Esophagus ◽  
Low Grade ◽  
High Grade ◽  
First Line ◽  
Mucosal Resection ◽  
First Line Therapy ◽  
Line Therapy ◽  
Low Grade Dysplasia

Barrett esophagus (BE) is a common premalignant condition that may evolve from nondysplastic intestinal metaplasia to low-grade dysplasia (LGD), high-grade dysplasia (HGD), and ultimately to esophageal adenocarcinoma (EAC). This review addresses the range of endoscopic approaches for treating dysplastic BE and early EAC. Endoscopic treatment is favored for most patients with LGD, although endoscopic surveillance continues to be an alternative. Endoscopic eradication is definitively recommended for patients with HGD. Radiofrequency ablation is the preferred technique for ablation of dysplastic BE, although there is also strong support for endoscopic mucosal resection as a first-line therapy. Cryotherapy is emerging as a valid alternative ablative approach. Endoscopic resection by endoscopic mucosal resection or endoscopic submucosal dissection is recommended as the first-line therapy for nodular BE and T1a EAC. Post-eradication endoscopic surveillance is indicated at intervals that depend on the category of pretreatment dysplasia. Because of advances in endoscopic therapy, surgery is now indicated only when endoscopic ablation or resection has failed or in the setting of more advanced EAC. This review contains 8 figures, 2 tables, and 55 references. Key Words: cryotherapy, endoscopic mucosal resection, esophageal adenocarcinoma, esophagectomy, high-grade dysplasia, low-grade dysplasia, nodular Barrett esophagus, radiofrequency ablation

Follow up of low grade sarcoma: The role of chest X-rays

2014 ◽  
Vol 67 (6) ◽  
pp. 882-884
Author(s):  
J.K. O'Neill ◽  
I. Gregory ◽  
C. McArdle ◽  
H. Taha ◽  
C. Millman ◽  
...  
Keyword(s):  
Low Grade ◽  
X Rays
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