title: Acetic acid chromoendoscopy: Improving neoplasia detection in Barrett's esophagus.
abstract: Barrett's esophagus (BE) is an important condition given its significant premalignant potential and dismal five-year survival outcomes of advanced esophageal adenocarcinoma. It is therefore suggested that patients with a diagnosis of BE undergo regular surveillance in order to pick up dysplasia at an earlier stage to improve survival. Current "gold-standard" surveillance protocols suggest targeted biopsy of visible lesions followed by four quadrant random biopsies every 2 cm. However, this method of Barrett's surveillance is fraught with poor endoscopist compliance as the procedures are time consuming and poorly tolerated by patients. There are also significant miss-rates with this technique for the detection of neoplasia as only 13% of early neoplastic lesions appear as visible nodules. Despite improvements in endoscope resolution these problems persist. Chromoendoscopy is an extremely useful adjunct to enhance mucosal visualization and characterization of Barrett's mucosa. Acetic acid chromoendoscopy (AAC) is a simple, non-proprietary technique that can significantly improve neoplasia detection rates. This topic highlight summarizes the current evidence base behind AAC for the detection of neoplasia in BE and provides an insight into the direction of travel for further research in this area.
authors.affiliation: Fergus JQ Chedgy, Sharmila Subramaniam, Kesavan Kandiah, Sreedhari Thayalasekaran, Pradeep Bhandari, Department of Gastroenterology, Queen Alexandra Hospital, PO6 3LY Portsmouth, United Kingdom.
authors.forename: Fergus J Q
authors.initials: FJ
authors.lastname: Chedgy
authors.affiliation: Fergus JQ Chedgy, Sharmila Subramaniam, Kesavan Kandiah, Sreedhari Thayalasekaran, Pradeep Bhandari, Department of Gastroenterology, Queen Alexandra Hospital, PO6 3LY Portsmouth, United Kingdom.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Subramaniam
authors.affiliation: Fergus JQ Chedgy, Sharmila Subramaniam, Kesavan Kandiah, Sreedhari Thayalasekaran, Pradeep Bhandari, Department of Gastroenterology, Queen Alexandra Hospital, PO6 3LY Portsmouth, United Kingdom.
authors.forename: Kesavan
authors.initials: K
authors.lastname: Kandiah
authors.affiliation: Fergus JQ Chedgy, Sharmila Subramaniam, Kesavan Kandiah, Sreedhari Thayalasekaran, Pradeep Bhandari, Department of Gastroenterology, Queen Alexandra Hospital, PO6 3LY Portsmouth, United Kingdom.
authors.forename: Sreedhari
authors.initials: S
authors.lastname: Thayalasekaran
authors.affiliation: Fergus JQ Chedgy, Sharmila Subramaniam, Kesavan Kandiah, Sreedhari Thayalasekaran, Pradeep Bhandari, Department of Gastroenterology, Queen Alexandra Hospital, PO6 3LY Portsmouth, United Kingdom.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Bhandari
mesh_terms: D019342:Acetic Acid; D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D001471:Barrett Esophagus / Q000175:diagnosis / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D006801:Humans; D007202:Indicators and Reagents; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid
keywords: Acetic acid; Barrett’s esophagus; Chromoendoscopy; Dysplasia; Esophageal adenocarcinoma