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| 1 | Low grade dysplasia in Barrett's esophagus:Should we worry?显示文摘The optimal management for low-grade dysplasia(LGD)in Barrett’s esophagus is unclear.In this article the importance of LGD is discussed,including the significant risk of progression to esophageal adenocarcinoma.Endoscopic surveillance is a management option but is plagued by sampling error and issues of suboptimal endoscopy.Furthermore endoscopic surveillance has not been demonstrated to be cost-effective or to reduce cancer mortality.The emergence of endoluminal therapy over the past decade has resulted in a paradigm shift in the management of LGD.Ablative therapy,including radiofrequency ablation,has demonstrated promising results in the management of LGD with regards to safety,cost-effectiveness,durability and reduction in cancer risk.It is,however,vital that a shareddecision making process occurs between the physician and the patient as to the preferred management of LGD.As such the management of LGD should be'individualised.' | Vamshi P Jagadesham Clive J Kelty | 2014 | World Journal of Gastrointestinal Pathophysiology2014，5，2： | 1 |
| 2 | Endoscopic mucosal resection of Barrett's esophagus detects high prevalence of subsquamous intestinal metaplasia显示文摘AIM:To report the prevalence of Subsquamous intestinal metaplasia(SSIM)in patients undergoing endoscopic mucosal resection(EMR)for staging of Barrett’s esophagus(BE).METHODS:Thirty-three patients with BE associated neoplasia underwent EMR at our institution between September 2009 and September 2011;22 of these patients met study inclusion criteria.EMR was targeted at focal abnormalities within the BE segment.EMR was performed in standardized fashion using a cap-assisted band ligation technique,and resection specimens were assessed for the presence of SSIM.Demographic and clinical data were analyzed to determine predictors of SSIM.RESULTS:SSIM was detected in 59%of patients.SSIM was detected in 73%of patients with short segment(<3 cm)BE,and in 45%of patients with longsegment(≥3 cm)BE(P=NS).There was no association between presence/absence of SSIM and age,gender,or stage of BE-associated neoplasia.CONCLUSION:EMR detects SSIM in a majority of patients with BE-associated neoplasia.While the longterm clinical significance of SSIM remains uncertain,these results highlight the importance of EMR as an optimal diagnostic tool for staging of BE and detection of SSIM,and should further limit concerns that SSIM is purely a post-ablation phenomenon. | Patrick Yachimski Chanjuan Shi James C Slaughter Mary Kay Washington | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，12： | 0 |
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