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• W3033258719 abstract "Endoscopic therapy with endoscopic resection (EMR) followed by ablation modalities such as radiofrequency ablation (RFA) or Balloon Cryotherapy (BC) is standard of care in the management of dysplastic Barrett’s esophagus (BE). RFA causes more superficial injury compared to BC. The integrity of the neosquamous epithelium after RFA has been shown to be impaired with dilated intercellular spaces (ICS) compared to native squamous epithelium. We hypothesized that the neo-squamous epithelium after BC will be characterized by a more robust epithelial barrier than after RFA. We aimed to assess the ICS diameter (measure of the structural integrity of the epithelial barrier), mucosal impedance (MI), a measure of the permeability of the epithelium, and thickness of the neosquamous epithelium on volumetric laser endomicroscopy (VLE) in patients achieving CRIM comparing those treated with RFA or BC. We prospectively enrolled 20 patients who achieved CRIM at two tertiary care centers. Of these 10 underwent BC and 10 underwent RFA. Biopsies were taken from the neo-squamous epithelium at 1 cm above the GEJ in the area of the prior BE segment and from the native squamous epithelium 1 cm above the prior BE segment. ICS diameter was measured using transmission electron microscopy (TEM) on these biopsies. Mucosal impedance (MI) was measured using a through the scope MI catheter at the same sites as biopsies. Volumetric Laser Endomicroscopy (VLE) was performed on 5 patients treated with RFA and 5 patients treated with BC to measure the neo-squamous epithelium thickness, at 1 cm above the GEJ (marked with real time laser marking). VLE measurements were performed by an expert blinded to the group assignment. Comparison of mean values of the ICS diameter, MI and epithelial thickness between RFA and BC groups was performed using pooled t-test. Baseline characteristics of patients in the two groups are listed in Table 1. Patients in the RFA group were younger and had longer pre-ablation BE segments than the BC group. No difference was seen in the mean ICS diameter of the native squamous epithelium between the two groups. The mean ICS diameter in post-RFA neosquamous epithelium was significantly larger than in the post-BC neosquamous epithelium (Table 2). The mean MI in the RFA group was also numerically lower than that of the BC group with a trend toward statistical significance (p=0.09). There was no statistically significant difference in the thickness of the neosquamous epithelium between the two groups. In this pilot study, we demonstrate that the structural and functional integrity of the neosquamous epithelium after BC may be more robust compared to the neosquamous epithelium after RFA despite similar thickness of the epithelium. These results need to be confirmed in larger studies.Table 2Structural and functional characteristics of the neosquamous epithelium in the two groups.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
• W3033258719 created "2020-06-12" @default.
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• W3033258719 date "2020-06-01" @default.
• W3033258719 modified "2023-09-30" @default.
• W3033258719 title "Mo1275 COMPARATIVE ASSESSMENT OF THE STRUCTURAL AND FUNCTIONAL INTEGRITY OF THE NEO-SQUAMOUS EPITHELIUM FOLLOWING ENDOSCOPIC THERAPY IN BARRETT'S ESOPHAGUS: A PILOT STUDY" @default.
• W3033258719 doi "https://doi.org/10.1016/j.gie.2020.03.2469" @default.
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