Table of Contents
International Scholarly Research Notices
Volume 2015, Article ID 735807, 6 pages
http://dx.doi.org/10.1155/2015/735807
Research Article

Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett’s Esophagus and Related Superficial Lesions

1Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
2Pathology Department, Royal Commission Medical Center (RCMC), Yanbu, Saudi Arabia

Received 16 July 2014; Revised 13 January 2015; Accepted 14 January 2015

Academic Editor: Vincenzo Savarino

Copyright © 2015 Hany M. Elsadek and Mamdouh M. Radwan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results. Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa , 95% CI: 0.170–0.69). Conclusions. Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients.