Document Detail


Acetic acid spray is an effective tool for the endoscopic detection of neoplasia in patients with Barrett's esophagus.
MedLine Citation:
PMID:  20601133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Diagnosis of Barrett's neoplasia requires collection of large numbers of random biopsy samples; the process is time consuming and can miss early-stage cancers. We evaluated the role of acetic acid chromoendoscopy in identifying Barrett's neoplasia.
METHODS: Data were collected from patients with Barrett's esophagus examined at a tertiary referral center, between July 2005 and November 2008 using Fujinon gastroscopes and EPX 4400 processor (n = 190). All procedures were performed by a single experienced endoscopist. Patients were examined with white light gastroscopy and visible abnormalities were identified. Acetic acid (2.5%) dye spray was used to identify potentially neoplastic areas and biopsy samples were collected from these, followed by quadrantic biopsies at 2 cm intervals of the remaining Barrett's mucosa. The chromoendoscopic diagnosis was compared with the ultimate histological diagnosis to evaluate the sensitivity of acetic acid chromoendoscopy.
RESULTS: Acetic acid chromoendoscopy had a sensitivity of 95.5% and specificity of 80% for the detection of neoplasia. There was a correlation between lesions predicted to be neoplasias by acetic acid and those diagnosed by histological analysis (r = 0.98). There was a significant improvement in the detection of neoplasia using acetic acid compared with white light endoscopy (P = .001).
CONCLUSIONS: Analysis of this large series showed that acetic acid-assisted evaluation of Barrett's esophagus detects neoplasia better than white light endoscopy, with sensitivity and specificity equal to that of histological analysis.
Authors:
Gaius Longcroft-Wheaton; Moses Duku; Robert Mead; David Poller; Pradeep Bhandari
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2010-06-30
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  8     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  843-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK.
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MeSH Terms
Descriptor/Qualifier:
Acetic Acid / diagnostic use*
Adult
Aged
Aged, 80 and over
Barrett Esophagus / complications*,  diagnosis*
Biopsy / methods
Esophageal Neoplasms / diagnosis*,  pathology*
Female
Gastroscopy / methods*
Histocytochemistry
Humans
Male
Microscopy
Middle Aged
Sensitivity and Specificity
Chemical
Reg. No./Substance:
64-19-7/Acetic Acid
Comments/Corrections
Comment In:
Nat Rev Gastroenterol Hepatol. 2010 Dec;7(12):653   [PMID:  21171213 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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