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.
Geisinger
K R
KR
Department of Pathology, Wake Forest University Medical Center, Winston-Salem, North Carolina, USA.
Sheppard
E A
EA
Teot
L A
LA
Raab
S S
SS
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