Incongruence between histologic and endoscopic diagnoses of Barrett's esophagus using transnasal esophagoscopy.
OBJECTIVE
The symptoms, patterns of reflux, and clinical manifestations of laryngopharyngeal reflux (LPR) differ from those of gastroesophageal reflux disease (GERD) in many ways. The purposes of this study were to determine the prevalence of Barrett's esophagus in patients with LPR using transnasal esophagoscopy (TNE) and to determine if there is agreement between TNE clinical findings and pathology results when using TNE for Barrett's screening.


METHODS
This study involved a retrospective review of the records of 200 consecutive patients with LPR undergoing esophageal screening.


METHODS
The prevalence of patients with findings clinically suspicious for Barrett's and the biopsy results for those patients were reviewed.


RESULTS
Of the 200 patients with LPR who were screened with TNE, 10% (20 of 200) had findings suspicious for Barrett's esophagus, and, of those, only 30% (six of 20) had biopsy-proven Barrett's metaplasia.


CONCLUSIONS
Although TNE may be a useful screening tool for Barrett's, there is incongruence between TNE findings and biopsy results, which likely reflects suboptimal biopsy methods with TNE. New biopsy techniques such as the CDx brush biopsy may enhance the sensitivity of TNE biopsies, and future studies are needed in this area.
Center for Voice and Swallowing Disorders of Wake Forest University, Department of Otolaryngology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1034, USA.
Stacey L
SL
Halum
Gregory N
GN
Postma
Dwight D
DD
Bates
Jamie A
JA
Koufman
D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence