[Usefulness of endoscopic biopsy in Barrett's esophagus].
OBJECTIVE
Endoscopy with random biopsies is the standard technique for the diagnosis of Barrett's esophagus (BE). We studied the usefulness of endoscopic biopsies in the diagnosis and surveillance of patients with BE.


METHODS
We reviewed all patients with BE controlled at the Hospital Clínic from February 2002 to March 2010.


RESULTS
During the study period, 493 endoscopies were performed in 206 patients. We excluded 86 patients who had undergone one endoscopy only, hence the final sample consisted of 117 patients (mean age 61 [12] years, 73% men) with 407 endoscopies and a mean follow-up of 45 (38) months. Fifty-seven patients had a short-BE (49%), 28 a long-BE (24%) and 32 (27%) could not be inferred from the report. In 25 cases (21%), intestinal metaplasia (IM) was not detected at the endoscopic index. During follow-up, biopsies were negative for IM at some point in 45 patients (38.4%) and there was a change in the histologic grade in 100 cases (24.6%). The presence of a short-BE (43% in short-BE vs 7% in long-BE, P=.001) and few biopsies (3 [1.5] vs 6.2 [4.5]; P=.005) were associated with a higher frequency of negative biopsies for IM.


CONCLUSIONS
Random endoscopic biopsies are not a good tool for diagnosis and surveillance of patients with BE.
Servicio de Aparato Digestivo, Hospital General de Catalunya, Barcelona, Spain.
Antonio
A
Rodríguez-D'Jesús
Henry
H
Córdova
J Ignasi
JI
Elizalde
Miriam
M
Cuatrecasas
Esteve
E
Saperas
Josep
J
Llach
Gloria
G
Fernández-Esparrach
D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D001706:Biopsy; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies