Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors
Background: The percentage of and factors associated with the regression of Barrett's esophagus (BE) or its characteristic intestinal metaplasia (IM) remain unclear, and conflicting results have been reported because of diverse regression and sampling error definitions. Thus, we investigated th...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623003200 |
| _version_ | 1827339771475656704 |
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| author | Kung-Hung Lin Jia-Bin Liao Yan-Hua Chen Huay-Min Wang Wei-Chih Sun Sung-Shuo Kao Tzung-Jiun Tsai Feng-Woei Tsay Wei-Lun Tsai Chao-Hsien Lee Wen-Chi Chen Hsien-Chung Yu |
| author_facet | Kung-Hung Lin Jia-Bin Liao Yan-Hua Chen Huay-Min Wang Wei-Chih Sun Sung-Shuo Kao Tzung-Jiun Tsai Feng-Woei Tsay Wei-Lun Tsai Chao-Hsien Lee Wen-Chi Chen Hsien-Chung Yu |
| author_sort | Kung-Hung Lin |
| collection | DOAJ |
| description | Background: The percentage of and factors associated with the regression of Barrett's esophagus (BE) or its characteristic intestinal metaplasia (IM) remain unclear, and conflicting results have been reported because of diverse regression and sampling error definitions. Thus, we investigated the rates of IM regression, sampling error, and associated factors. Methods: Forty-two patients with proven short-segment BE with IM who underwent two follow-up endoscopies with biopsies of Barrett's mucosa were retrospectively analyzed. Additional Alcian blue and MUC2 staining were done on the biopsy specimens without IM in hematoxylin–eosin staining. Only patients with negative hematoxylin–eosin, Alcian blue, and MUC2 staining for IM in both follow-up endoscopies were considered to have true regression. When all three stains were negative for IM in the first, but positive in the second follow-up endoscopy, we considered IM persisting and declared sampling error. Results: Among the 18 patients without IM at the first follow-up endoscopy, only five (11.9%) were judged to have true regression. Prolonged proton-pump inhibitor use was significantly associated with regression. Limited experience of the endoscopist, and insufficient biopsy number were significantly related to sampling error. Receiver operating characteristic (ROC) curve analysis showed the best cut-off value of the biopsy number/maximal-length (cm) ratio to predict sampling error was 2.25. Conclusion: In our patients with short-segment BE, 11.9% experienced regression of IM. Prolonged proton-pump inhibitors treatment was associated with regression. An insufficient biopsy number was related to a missed IM, which may be eliminated by maintaining biopsy number/maximal-length (cm) ratio ≥2.25. |
| first_indexed | 2024-03-07T20:05:33Z |
| format | Article |
| id | doaj.art-ece38b43ba324452943e0e9dcd553042 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-07T20:05:33Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-ece38b43ba324452943e0e9dcd5530422024-02-28T05:12:48ZengElsevierJournal of the Formosan Medical Association0929-66462024-02-011232238247Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factorsKung-Hung Lin0Jia-Bin Liao1Yan-Hua Chen2Huay-Min Wang3Wei-Chih Sun4Sung-Shuo Kao5Tzung-Jiun Tsai6Feng-Woei Tsay7Wei-Lun Tsai8Chao-Hsien Lee9Wen-Chi Chen10Hsien-Chung Yu11Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Pingtung Veterans General Hospital, Pingtung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Pingtung Veterans General Hospital, Pingtung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Health Business Administration, Meiho University, Pingtung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanHealth Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Corresponding author. Health Management Center, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Road, Zuoying District, Kaohsiung City 813414, Taiwan. Fax: +886 7 346 8357.Background: The percentage of and factors associated with the regression of Barrett's esophagus (BE) or its characteristic intestinal metaplasia (IM) remain unclear, and conflicting results have been reported because of diverse regression and sampling error definitions. Thus, we investigated the rates of IM regression, sampling error, and associated factors. Methods: Forty-two patients with proven short-segment BE with IM who underwent two follow-up endoscopies with biopsies of Barrett's mucosa were retrospectively analyzed. Additional Alcian blue and MUC2 staining were done on the biopsy specimens without IM in hematoxylin–eosin staining. Only patients with negative hematoxylin–eosin, Alcian blue, and MUC2 staining for IM in both follow-up endoscopies were considered to have true regression. When all three stains were negative for IM in the first, but positive in the second follow-up endoscopy, we considered IM persisting and declared sampling error. Results: Among the 18 patients without IM at the first follow-up endoscopy, only five (11.9%) were judged to have true regression. Prolonged proton-pump inhibitor use was significantly associated with regression. Limited experience of the endoscopist, and insufficient biopsy number were significantly related to sampling error. Receiver operating characteristic (ROC) curve analysis showed the best cut-off value of the biopsy number/maximal-length (cm) ratio to predict sampling error was 2.25. Conclusion: In our patients with short-segment BE, 11.9% experienced regression of IM. Prolonged proton-pump inhibitors treatment was associated with regression. An insufficient biopsy number was related to a missed IM, which may be eliminated by maintaining biopsy number/maximal-length (cm) ratio ≥2.25.http://www.sciencedirect.com/science/article/pii/S0929664623003200Barrett esophagusMetaplasiaRegressionSampling error |
| spellingShingle | Kung-Hung Lin Jia-Bin Liao Yan-Hua Chen Huay-Min Wang Wei-Chih Sun Sung-Shuo Kao Tzung-Jiun Tsai Feng-Woei Tsay Wei-Lun Tsai Chao-Hsien Lee Wen-Chi Chen Hsien-Chung Yu Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors Journal of the Formosan Medical Association Barrett esophagus Metaplasia Regression Sampling error |
| title | Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors |
| title_full | Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors |
| title_fullStr | Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors |
| title_full_unstemmed | Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors |
| title_short | Intestinal metaplasia in follow-up endoscopies among Asian patients with short-segment Barrett's esophagus: Regression, sampling error, and associated factors |
| title_sort | intestinal metaplasia in follow up endoscopies among asian patients with short segment barrett s esophagus regression sampling error and associated factors |
| topic | Barrett esophagus Metaplasia Regression Sampling error |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623003200 |
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