Wide-area transepithelial sampling for dysplasia detection in Barrett's esophagus: a systematic review and meta-analysis.

Adenocarcinoma / diagnostic imaging Barrett Esophagus / diagnostic imaging Biopsy Disease Progression Esophageal Neoplasms / diagnostic imaging Humans Precancerous Conditions Specimen Handling

Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
Jan 2022
Historique:
received: 28 04 2021
accepted: 04 09 2021
pubmed: 21 9 2021
medline: 4 1 2022
entrez: 20 9 2021
Statut: ppublish

Résumé

Seattle protocol forceps biopsy sampling (FB) is currently recommended for surveillance in Barrett's esophagus (BE) but limited by sampling error and lack of compliance. Wide-area transepithelial sampling with 3-dimensional analysis (WATS3D; CDx Diagnostics, Suffern, NY, USA) is reported to increase BE dysplasia detection. We assessed the incremental yield and clinical significance of WATS3D for dysplasia detection over FB in a systematic review and meta-analysis. We queried major scientific databases for studies using WATS3D and FB from 2000 to 2020. The primary outcome was the incremental yield of WATS3D-detected dysplasia (defined as a composite of indefinite for dysplasia, low- and high-grade dysplasia [HGD] and esophageal adenocarcinoma [EAC]) over FB. Secondary outcomes were incremental yields of HGD/EAC and rate of reconfirmation of WATS3D dysplasia on subsequent FB. Meta-analysis of 7 eligible studies demonstrated that FB diagnosed dysplasia in 15.9% of cases, whereas the incremental yield with WATS3D was 7.2% (95% confidence interval, 3.9%-11.5%; I WATS3D increases dysplasia detection; however, the clinical significance of this increased dysplasia detection remains uncertain. Data from endoscopic follow-up to ascertain FB histology in patients with dysplasia based solely on WATS3D are needed to determine the optimal clinical application and significance of WATS3D-only dysplasia.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Seattle protocol forceps biopsy sampling (FB) is currently recommended for surveillance in Barrett's esophagus (BE) but limited by sampling error and lack of compliance. Wide-area transepithelial sampling with 3-dimensional analysis (WATS3D; CDx Diagnostics, Suffern, NY, USA) is reported to increase BE dysplasia detection. We assessed the incremental yield and clinical significance of WATS3D for dysplasia detection over FB in a systematic review and meta-analysis.
METHODS METHODS
We queried major scientific databases for studies using WATS3D and FB from 2000 to 2020. The primary outcome was the incremental yield of WATS3D-detected dysplasia (defined as a composite of indefinite for dysplasia, low- and high-grade dysplasia [HGD] and esophageal adenocarcinoma [EAC]) over FB. Secondary outcomes were incremental yields of HGD/EAC and rate of reconfirmation of WATS3D dysplasia on subsequent FB.
RESULTS RESULTS
Meta-analysis of 7 eligible studies demonstrated that FB diagnosed dysplasia in 15.9% of cases, whereas the incremental yield with WATS3D was 7.2% (95% confidence interval, 3.9%-11.5%; I
CONCLUSIONS CONCLUSIONS
WATS3D increases dysplasia detection; however, the clinical significance of this increased dysplasia detection remains uncertain. Data from endoscopic follow-up to ascertain FB histology in patients with dysplasia based solely on WATS3D are needed to determine the optimal clinical application and significance of WATS3D-only dysplasia.

Identifiants

DOI: 10.1016/j.gie.2021.09.015 PMID: 34543648 PMC: PMC8671247
pubmed: 34543648
pii: S0016-5107(21)01646-1
doi: 10.1016/j.gie.2021.09.015
pmc: PMC8671247
mid: NIHMS1741207
pii:
doi:

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

51-59.e7

Subventions

Organisme : NCI NIH HHS
ID : P50 CA150964
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA241164
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA163060
Pays : United States

Informations de copyright

Copyright © 2022 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Auteurs

D Chamil Codipilly (DC)

Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

Apoorva Krishna Chandar (A)

Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

Kenneth K Wang (KK)

Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

David A Katzka (DA)

Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

John R Goldblum (JR)

Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Prashanthi N Thota (PN)

Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Gary W Falk (GW)

Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Amitabh Chak (A)

Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Division of Gastroenterology and Liver Diseases, Case Western Reserve University, Cleveland, Ohio, USA.

Prasad G Iyer (PG)

Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

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Classifications MeSH

questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Carcinomes › Adénocarcinome › Wide-area transepithelial sampling for...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies de l'oesophage › Oesophage de Barrett › Wide-area transepithelial sampling for...
questionsmedicales.fr › Techniques d'investigation › Techniques cytologiques › Cytodiagnostic › Biopsie › Wide-area transepithelial sampling for...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Évolution de la maladie › Wide-area transepithelial sampling for...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Tumeurs gastro-intestinales › Tumeurs de l'oesophage › Wide-area transepithelial sampling for...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Wide-area transepithelial sampling for...
questionsmedicales.fr › Tumeurs › États précancéreux › Wide-area transepithelial sampling for...
questionsmedicales.fr › Techniques d'investigation › Techniques de laboratoire clinique › Manipulation d'échantillons › Wide-area transepithelial sampling for...