Advertisement

Digestive Diseases and Sciences

, Volume 46, Issue 12, pp 2681–2686 | Cite as

Cytological Screening for Barrett's Esophagus Using a Prototype Flexible Mesh Catheter

  • Anne E. Rader
  • Douglas O. Faigel
  • John Ditomasso
  • Nathan Magaret
  • Michael Burm
  • M. Brian Fennerty
Article

Abstract

The current cost of endoscopically screening patients with gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE) is considerable. A nonendoscopic device that allows for screening of these patients would offer significant cost savings. This pilot study evaluates the utility of cytologically diagnosing BE using a prototype flexible mesh catheter. Patients with known BE undergoing indicated surveillance endoscopy were enrolled in the study. Cytology specimens were obtained using a prototype flexible catheter and were evaluated for the presence of glandular cells, goblet cells, squamous cells, inflammation, and dysplasia. Eleven patients with BE were enrolled in the study. None of the patients experienced complications. Specimens from eight patients (73%) were adequate for evaluation and seven of these patients (87.5%) had goblet cells diagnostic for BE. In conclusion, flexible mesh catheters potentially offer a sensitive, inexpensive, and minimally invasive approach to evaluating patients with GERD and BE.

Barrett's esophagus catheter gastroesophageal reflux disease screening 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Locke GR 3rd, Talle NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd: Prevalence and clinical spectrum of gastroesophageal re-flux: a population-based study in Olmstead county, Minnesota. Gastroenterology 112(5):1448–1456, 1997Google Scholar
  2. 2.
    Winters C Jr, Spurling TJ, Chobanian SJ, Curtis DJ, Esposito RL, Hacker JF 3rd, Johnson DA, Cruess DF, Cotelingam JK, Gurney MS: Barrett' esophagus, a prevalent occult complication in gastroesophageal reflux disease. Gastroenterology 92(1):118–124, 1987Google Scholar
  3. 3.
    Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr: Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 265(10):1287–1289, 1991Google Scholar
  4. 4.
    Sampliner RE: Practice guidelines on the diagnosis, surveillance and therapy of Barrett' esophagus. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 93(7):1028–1032, 1998Google Scholar
  5. 5.
    Provenzale D, Kemp JA, Arora S, Wong JB: A guide for surveillance of patients with Barrett' esophagus. Am J Gastroenterol 89(5):670–680, 1994Google Scholar
  6. 6.
    Shen O, Liu SF, Dawsey SM: Cytologic screening for esophageal cancer: results from 12,877 subjects from a high-risk population in China. Int J Cancer 54(2):185–188, 1993Google Scholar
  7. 7.
    Brandt LJ, Coman E, Schwatz E, Schoen RE, Siciliano G, Surland M, Chacho M: Use of a new cytology balloon for diagnosis of symptomatic esophageal disease and acquired immunodeficency syndrome. Gastrointes Endosc 39(1):559–561, 1993Google Scholar
  8. 8.
    Falk GW, Chittajallu R, Goldblum JR, Biscotti CV, Geisinger KR, Petras RE, Birgissons S, Rice TW, Richter JE: Surveillance of patients with Barrett' esophagus for dysplasia and cancer with balloon cytology. Gastroenterology 112(6):1787–1797, 1997Google Scholar
  9. 9.
    Fennerty MB, DiTomasso J, Morales TG, Peterson D, Karmakar A, Fernandez T, Sampliner R: Screening for Barrett' esophagus by balloon cytology. Am J Gastroenterol 90(8):1230–1232, 1995.Google Scholar
  10. 10.
    Weinstein WM, Ippoliti AF: The diagnosis of Barrett' esophagus: goblets, goblets, goblets. Gastrointest Endosc 44(1):91–95, 1996Google Scholar
  11. 11.
    Geisinger KR, Teot LA, Richter JE: A comparative cytopathologic and histologic study of atypia, dysplasia, and adenocarcinoma in Barrett' esophagus. Cancer 69(1):8–16, 1992Google Scholar
  12. 12.
    Wang HH, Doria MI, Purohit-Bush S, Schnell T, Sontag S, Chejfec G: The cytology of dysplasia in comparison to benign and malignant lesions. Acta Cytol 36(1):60–64, 1992Google Scholar
  13. 13.
    Wang HH, Sovie S, Zeroogian JM, Spechler SJ, Goyal RK, Antoniolo DA: Value of cytology in detecting intestinal metaplasia and associated dysplasia at the gastroesophageal junction. Hum Pathol 28(4):465–471, 1997Google Scholar
  14. 14.
    Spechler SJ: The columnar lined oesophagus: A riddle wrapped in a mystery inside an enigma. Gut 41(5):710–711, 1997Google Scholar
  15. 15.
    Weston AP, Krmpotich PT, Makdisi WF, Cherian R, Dixon A, McGregor DH, Banerjee SK: Short segment Barrett' esophagus: Clinical and histological features, associated endoscopic findings, and association with gastric intestinal metaplasia. Am J Gastroenterol 91(5):981–986, 1996Google Scholar
  16. 16.
    Johnston MH, Hammond AS, Laskin W, Jones DM: The prevalence and clinical characteristics of short segments of specialized intestinal metaplasia in the distal esophagus on routine endoscopy. Am J Gastroenterol 91(8):1507–1511, 1996Google Scholar
  17. 17.
    Pera M, Cameron AJ, Trastek VF, Carpenter HA, Zinsmeister AR: Increasing incidence of adenocarcinoma of the esophagus and esophagogastric junction. Gastroenterology 104(2):510–513, 1993Google Scholar
  18. 18.
    Schnell TG, Sontag SJ, Chejfec G: Adenocarcinomas arising in tongues of short segments of Barrett' esophagus. Dig Dis Sci 37(1):137–143, 1992Google Scholar
  19. 19.
    Cameron AJ, Lomboy CT, Pera M, Carpenter HA: Adenocarcinoma of the esophagogastric junction and Barrett' esophagus. Gastroenterology 109:1541–1546, 1995Google Scholar
  20. 20.
    Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr.: Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 265:1287–1289, 1991Google Scholar
  21. 21.
    Haggitt RC: Barrett' esophagus, dysplasia, and adenocarcinoma. Hum Pathol 25(10):982–993, 1994Google Scholar
  22. 22.
    Levine DS, Haggitt RC, Blount PL, Rabinovitch PS, Rusch VW, Reid BJ: An endoscopic biopsy protocol can differentiate high-grade dysplasia from early adenocarcinoma in Barrett' esophagus. Gastroenterology 105(5):40–50, 1993Google Scholar
  23. 23.
    Reid BJ, Haggitt RC, Rubin CE, Roth G, Surawicz CM, Van Belle G, Lewin K, Weinstein WM, Antonioli DA, Goldman H: Observer variation in the diagnosis of dysplasia in Barrett' esophagus. Hum Pathol 19(2):166–178, 1988Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Anne E. Rader
    • 1
  • Douglas O. Faigel
    • 2
  • John Ditomasso
    • 3
  • Nathan Magaret
    • 2
  • Michael Burm
    • 2
  • M. Brian Fennerty
    • 2
  1. 1.Department of PathologyOregon Health Sciences University and Veterans Administration Medical CenterPortland
  2. 2.Department of Medicine, Division of GastroenterologyOregon Health Sciences University and Veterans Administration Medical CenterPortland
  3. 3.Pathology Consultants, P.C.Eugene

Personalised recommendations