Portal de Periódicos da CAPES

Current status of endoscopic diagnosis and treatment of superficial B arrett's adenocarcinoma in A sia– P acific region

2013; Wiley; Volume: 25; Issue: S2 Linguagem: Inglês

10.1111/den.12093

1443-1661

Kenichi Goda, Rajvinder Singh, Ichiro Oda, Masami Omae, Akiko Takahashi, Tomoyuki Koike, Noriya Uedo, Dai Hirasawa, Mitsuhiro Fujishiro, Kingo Hirasawa, Yoshinori Morita, Lawrence KY Ho, Yoichi Ajioka,

Esophageal and GI Pathology

The incidence of B arrett's adenocarcinoma has increased dramatically over the past few decades in most W estern countries. While B arrett's esophagus is uncommon and adenocarcinoma is still rare in A sian populations, several A sian studies have indicated that the prevalence of esophageal adenocarcinoma is gradually increasing. Therefore, in order to determine the best way to treat superficial B arrett's adenocarcinoma, 12 expert endoscopists and a pathologist from the A sia– P acific region conducted a session entitled ‘ T he current status of endoscopic diagnosis and treatment of superficial B arrett's adenocarcinoma’. After three keynote lectures, three J apanese panels presented cases of superficial B arrett's adenocarcinomas diagnosed by image‐enhanced endoscopy ( IEE ). We then confirmed the results of a questionnaire on the diagnosis and treatment of superficial B arrett's adenocarcinomas. Finally, a panel introduced an A sia– P acific international study on simplified narrow‐band imaging ( NBI ) classification of B arrett's esophagus and neoplasias. After adiscussion, we proposed consensus statements on endoscopic diagnosis and treatment of superficial B arrett's adenocarcinoma as follows. Representative characteristics by conventional white light endoscopy are a reddish area or a lesion located on the anterior to right side wall. IEE may be useful for characterizing the tumor and diagnosing lateral tumor extension. Superficial B arrett's adenocarcinoma adjacent to the squamocolumnar junction is sometimes associated with subsquamous tumor extension. IEE may be useful to detect the subsquamous tumor extension especially when using NBI or an acetic acid‐spraying method. Endoscopic mucosal resection or endoscopic submucosal dissection for mucosal carcinomas could provide excellent prognosis.