Document Detail


The effect of reactive atypia/inflammation on the laser-induced fluorescence diagnosis of non-dysplastic Barrett's esophagus.
MedLine Citation:
PMID:  22535652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Differential Normalized Fluorescence (DNF) technique has been used to distinguish high-grade dysplasia from non-dysplastic Barrett's esophagus. This technology may assist gastroenterologists in targeting biopsies, reducing the number of biopsies using the standard protocol. In the presence of reactive atypia/inflammation, it becomes difficult for the pathologist to differentiate non-dysplastic Barrett's esophagus from Barrett's esophagus with low-grade dysplasia. Before DNF technique may be used to guide target biopsies, it is critical to know whether reactive atypia/inflammation in non-dysplastic Barrett's may result in false positives. This study was conducted to determine whether DNF technique is adversely affected by the presence of reactive atypia/inflammation in non-dysplastic Barrett's esophagus resulting in false positives.
STUDY DESIGN/MATERIALS AND METHODS: Four hundred ten-nanometer laser light was used to induce autofluorescence of Barrett's mucosa in 49 patients. The clinical study included 37 males and 12 females. This was a blinded retrospective data analysis study. A total of 303 spectra were collected and matched to non-dysplastic Barrett's biopsy results. One hundred seventy-five spectra were collected from areas with a pathology of non-dysplastic Barrett's esophagus with reactive atypia/inflammation. One hundred twenty-eight spectra were collected from areas with non-dysplastic Barrett's esophagus without reactive changes/inflammation. The spectra were analyzed using the DNF Index at 480 nm and classified as positive or negative using the threshold of -0.75 × 10(-3).
RESULTS: Using DNF technique, 92.6% of non-dysplastic samples with reactive atypia/inflammation were classified correctly (162/175). 92.2% of non-dysplastic samples without reactive atypia/inflammation were classified correctly (118/128). Comparing the ratios of false positives among the two sample groups, there was not a statistically significant difference between the two groups.
CONCLUSION: Using DNF technique for classification of non-dysplastic Barrett's mucosa does not result in false-positive readings due to reactive atypia/inflammation. Target biopsies guided by DNF technique may drastically reduce the number of pinch biopsies using the standard biopsy protocol.
Authors:
Masoud Panjehpour; Bergein F Overholt; Tuan Vo-Dinh; Domenico Coppola
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-25
Journal Detail:
Title:  Lasers in surgery and medicine     Volume:  44     ISSN:  1096-9101     ISO Abbreviation:  Lasers Surg Med     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-08     Completed Date:  2012-10-11     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  8007168     Medline TA:  Lasers Surg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Laser Center, Thompson Cancer Survival Center, Knoxville, TN 37916, USA. mpanjehp@covhlth.com
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MeSH Terms
Descriptor/Qualifier:
Barrett Esophagus / complications,  pathology*
Biopsy
Diagnosis, Differential
Esophagoscopy / instrumentation,  methods*
Esophagus / pathology*
False Positive Reactions
Female
Humans
Inflammation / etiology
Lasers, Dye / diagnostic use*
Male
Retrospective Studies
Single-Blind Method
Spectrometry, Fluorescence / instrumentation,  methods*
Grant Support
ID/Acronym/Agency:
R01 CA088787/CA/NCI NIH HHS; R01 CA088787-01/CA/NCI NIH HHS
Comments/Corrections

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


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