Dysplasia in Barrett esophagus.
BACKGROUND
Dysplasia in Barrett esophagus is a premalignant condition that is associated with an increased risk of developing esophageal adenocarcinoma. Unfortunately, clinical investigation aimed at prevention of progression to malignant disease has been hampered by the variable prevalence of dysplasia reported in the literature. The objective of the current study was to more accurately determine the prevalence of dysplasia among individuals with Barrett esophagus who would be available for enrollment in a chemoprevention trial.


METHODS
The pathology archives of 3 institutions were reviewed over a 5-year period for all reports of diagnoses of Barrett esophagus. Surgical cases, malignancies, and duplicate or referral cases were excluded from the analysis.


RESULTS
A total of 790 cases of Barrett esophagus were identified. Of these, 37 (4.7%) were cases of low-grade dysplasia (LGD), and 20 (2.5%) were cases of high-grade dysplasia. The University of Michigan Medical Center (Ann Arbor, MI) diagnosed 18 cases of LGD, Henry Ford Hospital (Detroit, MI) diagnosed 15 cases of LGD, and Brigham and Women's Hospital (Boston, MA) diagnosed 4 cases of LGD in patients with Barrett esophagus over the 5-year study period.


CONCLUSIONS
The confirmed low prevalence of cases of LGD will affect the design of future clinical trials of chemopreventive interventions for Barrett esophagus.
Lao
Christopher D
CD
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.
Simmons
Melanie
M
Syngal
Sapna
S
Bresalier
Robert S
RS
Fortlage
Laurie
L
Normolle
Daniel
D
Griffith
Kent A
KA
Appelman
Henry D
HD
Brenner
Dean E
DE
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications*; D018890:Chemoprevention; D002986:Clinical Trials as Topic; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000473:pathology* / Q000517:prevention & control; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors