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Routinely diagnosed low-grade dysplasia in Barrett's oesophagus: a population-based study of natural history

Gatenby, P; Ramus, J; Caygill, C; Shepherd, N; Winslet, M; Watson, A; (2009) Routinely diagnosed low-grade dysplasia in Barrett's oesophagus: a population-based study of natural history. HISTOPATHOLOGY , 54 (7) 814 - 819. 10.1111/j.1365-2559.2009.03316.x.

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Abstract

To examine the natural history of columnar-lined oesophagus with routinely diagnosed low-grade dysplasia and ascertain the risk of oesophageal adenocarcinoma development.A multicentre retrospective cohort study of 283 patients with low-grade dysplasia. Follow-up data were obtained from examination of hospital records. One hundred and forty-four patients had biopsies prior to low-grade dysplasia diagnosis and 217 had follow-up biopsies after index low-grade dysplasia diagnosis. In these patients the incidence of high-grade dysplasia and adenocarcinoma combined was 4.6% per annum and of adenocarcinoma alone was 2.7% per annum. At most recent follow-up, 43 (19.8%) had persistent low-grade dysplasia, 37 (17.1%) had changes indefinite for dysplasia and 108 (49.8%) had non-dysplastic columnar-lined oesophagus. When prevalent cases were excluded (those occurring within 1 year of index low-grade dysplasia diagnosis), the annual incidence of high-grade dysplasia and adenocarcinoma combined was 2.2% and of adenocarcinoma alone was 1.4%. The relative risk for adenocarcinoma development in low-grade dysplasia compared with non-dysplastic columnar-lined oesophagus was 2.871 (P = 0.002).Low-grade dysplasia has a threefold increased risk of progression to cancer compared with non-dysplastic epithelium, but in the majority of patients dysplasia is not subsequently detected.

Type:Article
Title:Routinely diagnosed low-grade dysplasia in Barrett's oesophagus: a population-based study of natural history
DOI:10.1111/j.1365-2559.2009.03316.x
Keywords:Barrett's oesophagus, dysplasia, oesophageal cancer, surveillance, COLUMNAR-LINED ESOPHAGUS, INTRAEPITHELIAL NEOPLASIA, ADENOCARCINOMA RISK, UPDATED GUIDELINES, INNOCENT BYSTANDER, PROGRESSION, EPITHELIUM, CANCER, COHORT, SURVEILLANCE
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)

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