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Study shows in vivo endomicroscopy improves detection of Barrett's esophagus-related neoplasia
Date:2/19/2014

DOWNERS GROVE, Ill. February 19, 2014 New research shows that the addition of confocal laser endomicroscopy to high-definition white-light endoscopy enables improved real-time endoscopic diagnosis of Barrett's esophagus dysplasia (neoplastic tissue) by using targeted biopsies of abnormal mucosa to reduce unnecessary mucosal biopsies and potentially reduce costs. It may also positively influence patient care by changing the plan for immediate endoscopic management. The study appears in the February issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Barrett's esophagus (BE) is a precancerous change in the epithelial lining of the esophagus that is associated with the development of esophageal cancer. The current best, though imperfect, marker of neoplastic progression is dysplasia (abnormality in cells which have undergone early changes on a path toward possible malignancy) detected in mucosal biopsy specimens of the lining of the esophagus obtained at the time of endoscopy. High-grade dysplasia is associated with a high rate of progression to invasive esophageal cancer. Detection and pathologic confirmation of early BE neoplasia (high-grade dysplasia or early esophageal cancer) is important because endoscopic therapy at this point is highly successful. Unfortunately, neoplasia in BE may not be evident even with only endoscopic inspection, so the current standard of care is endoscopic surveillance with high-quality white-light endoscopy using systematic 4-quadrant biopsies every 1 to 2 cm of BE length and targeted biopsies of any mucosal irregularities. A large number of biopsies may be required using this random biopsy method, resulting in high cost and increased time. This method has a low (1 percent to 10 percent) diagnostic yield for neoplasia and may result in lower adherence to practice guidelines.

Confocal laser endomicroscopy (CLE
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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