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• W2977625744 abstract "Introduction: Low grade dysplasia (LGD) is a known risk factor for progression to high grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in Barrett's esophagus (BE). Though recent studies have shown that ablation reduces risk of progression in BE-LGD, progression estimates vary. Factors predicting increased risk of progression in BE LGD remain unknown with smaller studies reporting conflicting data on the impact of confirmation of LGD by expert GI pathologists on progression risk. We aimed to assess the effect of independent confirmation of LGD diagnosis by a panel of two GI pathologists on progression risk in a cohort of BE-LGD subjects.Table 1: Characteristics of the Study SampleMethods: All subjects with a histologic diagnosis of LGD (made by a GI pathologist) in a prospective multicenter BE registry were identified. This registry has records of demographic details, endoscopic findings and histologic data from esophageal biopsies. The biopsy slides from index date (date of initial diagnosis of LGD) were reviewed by a panel of two expert GI pathologists using a double headed scope to reach a consensus diagnosis. Pathology was classified as EAC, HGD, LGD, indefinite (IND) or no dysplasia (NDBE). Progressors were defined as subjects who developed HGD / EAC more than 12 months after index date. Cox proportional hazard models were used to evaluate if additional confirmation of LGD diagnosis increased the risk of progression. Results: 352 BE-LGD subjects were identified, of which 249 subjects had biopsy slides available for review. The mean (SD) age was 64.3 (11.4) years. 201 (80.7%) were males. The mean follow up of subjects was 7.8 years. 15 subjects progressed to HGD/EAC with an annual risk of progression of 0.8 %. Following review by the pathologists' panel, the histologic diagnosis was LGD (92 patients) or IND (91 patients) in 73.5%, and NDBE (66 patients) in 26.5% of study subjects. Baseline characteristics of the subjects are summarized in table1. The progression risk in subjects with additional confirmation of LGD/IND was significantly higher than those downstaged to NDBE group [log-rank p=0.027, figure 1]. After adjusting for age, sex and BE length, the difference in progression risk stayed intact (HR 9.1, 95% CI 1.2-70.4, p=0.034).Figure 1Conclusion: In this large well-defined cohort of BE-LGD patients, all with expert GI pathologist confirmation, progression risk increases 9 fold when an additional panel of expert GI pathologists confirm a LGD/IND diagnosis. These BE subjects may be candidates for endoscopic therapy." @default.
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• W2977625744 date "2015-10-01" @default.
• W2977625744 modified "2023-10-16" @default.
• W2977625744 title "Impact of Histology Confirmation by GI Pathologist Panel on Progression Rates in Barrettʼs Esophagus With Low-Grade Dysplasia: Results From a Multicenter Prospective BE Registry" @default.
• W2977625744 doi "https://doi.org/10.14309/00000434-201510001-01724" @default.
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