Histopathologic practices for esophageal biopsy specimens: survey results and implications for surveillance in patients with Barrett's esophagus.
A clinically valuable interpretation of esophageal biopsy specimens begins with well-prepared histologic sections. This may be especially true for reflux esophagitis and Barrett's glandular dysplasia. To determine exactly which histologic procedures are used by experts in gastrointestinal pathology, a checklist survey was mailed to 50 members of the Gastrointestinal Pathology Society. Responses were received from 42 (84%). Formalin, used 80% of the time, is overwhelmingly the most popular fixative. Orientation of biopsy material before further processing is performed in 36% of the institutions, most often (53%) by an endoscopy technician. The most frequently used (60%) substrate for orientation is filter material. The most common (83%) routine procedure uses only H&E staining. Others routinely add a mucin reaction to the H&E. Eleven different practices for sectioning are used; the most common (43%) is serial step sectioning at 3 levels. One third of the responders had a formal surveillance program for patients with Barrett's esophagus. For esophageal biopsy specimens, a broad spectrum of histologic practices exists. Trends for the more complex histotechnologic procedures to be used by those involved in screening for dysplastic Barrett's epithelium are evident.
Department of Pathology, Wake Forest University Medical Center, Winston-Salem, North Carolina, USA.
K R
KR
Geisinger
E A
EA
Sheppard
L A
LA
Teot
S S
SS
Raab
D001471:Barrett Esophagus / Q000473:pathology*; D001706:Biopsy / Q000191:economics; D003625:Data Collection; D004947:Esophagus / Q000473:pathology*; D017048:Health Care Costs; D006652:Histological Techniques; D006801:Humans; D011159:Population Surveillance; D013194:Staining and Labeling