caa a22 4500 445795166 CHVBK 20180317145122.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s10620-010-1459-z doi (NATIONALLICENCE)springer-10.1007/s10620-010-1459-z Computer-Assisted Brush-Biopsy Analysis for the Detection of Dysplasia in a High-Risk Barrett's Esophagus Surveillance Population [Elektronische Daten] [Sharmila Anandasabapathy, Stephen Sontag, David Graham, Stephen Frist, Joan Bratton, Noam Harpaz, Jerome Waye] Background: Barrett's epithelial dysplasia, the direct precursor to esophageal adenocarcinoma, is often unapparent and frequently missed during surveillance of Barrett's esophagus with four-quadrant forceps biopsy protocol. Aim: To determine whether the detection of dysplasia is improved by adding computer-assisted brush biopsy (EndoCDx©) to four-quadrant biopsy protocol. Methods: Patients with a history of Barrett's esophagus with dysplasia scheduled for endoscopic surveillance were recruited from four academic medical centers. Patients underwent brush biopsy followed by four-quadrant biopsy every 1-2cm. The results from brush and forceps biopsy were reviewed independently by pathologists blinded to the other's results. Results: Among 151 patients enrolled (124 men, 27 women; mean age: 65), 117 (77.5%) had forceps and brush-biopsy specimens adequate for interpretation. The mean number of forceps biopsies was 11.9 (median 10, range 2-40) and brush biopsies was 2.0 (median 2, range 1-4). The overall yield of forceps alone was 25.2% (n=38). Brush biopsy added an additional 16 positive cases increasing the yield of dysplasia detection by 42% (95% CI: 20.7-72.7). The number needed to test (NNT) to detect one additional case of dysplasia was 9.4 (95% CI: 6.4-17.7). There were no significant differences in results among different centers, between standard versus jumbo forceps, or between forceps biopsies taken every 1cm versus every 2cm. Conclusions: These data suggest that computer-assisted brush biopsy is a useful adjunct to standard endoscopic surveillance regimens for the identification of dysplasia in Barrett's esophagus. Springer Science+Business Media, LLC, 2010 Barrett's esophagus nationallicence Esophageal cancer nationallicence Cytology nationallicence Brush biopsy nationallicence Endoscopy nationallicence Anandasabapathy Sharmila Division of Gastroenterology, The Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY, USA aut Sontag Stephen The Hines-VA Medical Center, Chicago, IL, USA aut Graham David Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA aut Frist Stephen CDx Laboratories, Suffern, NY, USA aut Bratton Joan Division of Gastroenterology, The Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY, USA aut Harpaz Noam Department of Pathology, The Mount Sinai Medical Center, 10029, New York, NY, USA aut Waye Jerome Division of Gastroenterology, The Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/3(2011-03-01), 761-766 0163-2116 56:3<761 2011 56 10620 https://doi.org/10.1007/s10620-010-1459-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1459-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Anandasabapathy Sharmila Division of Gastroenterology, The Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY, USA aut NATIONALLICENCE 700 1- Sontag Stephen The Hines-VA Medical Center, Chicago, IL, USA aut NATIONALLICENCE 700 1- Graham David Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA aut NATIONALLICENCE 700 1- Frist Stephen CDx Laboratories, Suffern, NY, USA aut NATIONALLICENCE 700 1- Bratton Joan Division of Gastroenterology, The Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY, USA aut NATIONALLICENCE 700 1- Harpaz Noam Department of Pathology, The Mount Sinai Medical Center, 10029, New York, NY, USA aut NATIONALLICENCE 700 1- Waye Jerome Division of Gastroenterology, The Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/3(2011-03-01), 761-766 0163-2116 56:3<761 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer