Surveillance of patients with Barrett's esophagus for dysplasia and cancer with balloon cytology

被引:96
作者
Falk, GW
Chittajallu, R
Goldblum, JR
Biscotti, CV
Geisinger, KR
Petras, RE
Birgisson, S
Rice, TW
Richter, JE
机构
[1] CLEVELAND CLIN FDN,DEPT PATHOL ANAT,CLEVELAND,OH 44195
[2] CLEVELAND CLIN FDN,DEPT THORAC SURG,CLEVELAND,OH 44195
[3] WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PATHOL,WINSTON SALEM,NC 27103
关键词
D O I
10.1053/gast.1997.v112.pm9178668
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: A less costly cancer surveillance method for Barrett's esophagus is desirable, The aim of this study was to compare nonendoscopic balloon cytology with biopsy and brush cytology for detecting dysplasia and carcinoma in patients with Barrett's esophagus, Methods: Patients in a surveillance program underwent balloon cytology before endoscopy with biopsy and brush cytology, Results of cytology were compared with those of histology, Results: Adequate columnar epithelium was obtained in 52 of 63 (83%) patients with balloon cytology and 59 of 61 (97%) with brush cytology, Balloon cytology obtained abnormal cells in 6 of 8 patients with adenocarcinoma, 2 of 2 patients with high-grade dysplasia, and 2 of 8 patients with low-grade dysplasia, Sensitivity of balloon cytology for high-grade dysplasia or carcinoma was 80% but only 25% for low-grade dysplasia, No patients without dysplasia or carcinoma had abnormal cells. Brush cytology was abnormal in all 11 patients with high-grade dysplasia or carcinoma but only 2 of 9 patients with low-grade dysplasia (sensitivity, 22%), Two of 39 patients without dysplasia had abnormal cells (specificity, 95%), Balloon cytology cost was sixfold less than endoscopy with biopsy, Conclusions: Balloon cytology detected 80% of patients with high-grade dysplasia or carcinoma when sampling was adequate, Brush cytology data suggest that a move abrasive balloon may improve balloon cytology sensitivity, The potential cost savings of balloon cytology compared with endoscopic cancer surveillance in Barrett's esophagus support further studies of this technique.
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页码:1787 / 1797
页数:11
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