Best of GIE | December 2021-Barretts Esophagus Low Grade Dysplasia

Pdf Summary

A study conducted at Barrett’s esophagus referral units (BERUs) in Australia found that the rate of progression from low-grade dysplasia (LGD) to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) may be overestimated. The study included 75 patients who had been referred from the community with a recent diagnosis of LGD. After an endoscopic assessment at BERUs, 27% of these patients were found to have HGD or EAC. This suggests that some cases of apparent progression from LGD may actually be due to prevalent advanced disease that was missed during initial assessments. The study also found that BERU assessments identified more visible lesions than endoscopies performed in the community, indicating that expert assessment may improve the detection of advanced lesions. Additionally, the study found that a higher proportion of patients had a confirmed diagnosis of LGD when their original community slides were reviewed by an expert GI pathologist, further emphasizing the importance of expert review in accurately diagnosing LGD. The findings suggest that the wide range of reported LGD progression rates in the literature may be influenced by inadequate community assessments. The study concludes that patients with a community diagnosis of LGD should be referred to BERUs for further assessment and management.

Asset Subtitle

Complete title: Barrett’s esophagus with low-grade dysplasia: high rate of upstaging at Barrett’s esophagus referral units suggests progression rates may be overestimated

Meta Tag

Disease Esophageal Adenocarcinoma

Organ & Anatomy Esophagus

Keywords

Barrett's esophagus referral units

Australia

progression rate

low-grade dysplasia

high-grade dysplasia

esophageal adenocarcinoma

endoscopic assessment

advanced disease

expert assessment

GI pathologist