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Risk of malignant progression of Barrett's oesophagus
Published estimates of the annual risk of cancer in patients with Barrett's oesophagus (BO) vary widely and range from 0% to 2.9% per annum. The variation may be partly explained by publication bias favouring small studies with high cancer incidence rates. In this study, De Jonge et al estimated the progression rate of BO to high-grade dysplasia (HGD) and oesophageal adenocarcinoma (OAC) in a nationwide cohort of patients with BO in The Netherlands, and assessed the value of the factors age, sex and initial histology as predictors of malignant progression in BO. A total of 42 207 patients with BO were included; 4132 (8%) of them had low-grade dysplasia. Patients were followed-up for a total of 78 131 person-years. Incidence rates per 1000 person-years were 4.3 (95% CI 3.4 to 5.5) for OAC and 5.8 (95% CI 4.6 to 7.0) for HGD/OAC combined. Risk factors for HGD/OAC were increased age, male gender and presence of low-grade dysplasia at baseline. This is the largest cohort of unselected patients with BO and the estimates reported should enable an improved risk assessment in BO (see figure). See page 1030
Progression rate to high-grade dysplasia (HGD)/oesophageal adenocarcinoma (OAC) in 16 333 patients with Barrett's oesophagus.
Molecular imaging of VEGF using confocal laser endomicroscopy
Confocal laser endomicroscopy (CLE) allows in vivo histological examination of the gastrointestinal tract in real time during endoscopy, but the feasibility of ‘in vivo immunohistochemistry’ using fluorescence labelled monoclonal antibodies remains unanswered. Vascular endothelial growth factor …
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- Oesophagus
- Hepatology
- Hepatology
- Small bowel
- Inflammatory bowel disease
- Endoscopy