HISTOPATHOLOGICAL DIAGNOSTIC CRITERIA OF BARRETT ESOPHAGUS AND ITS ASSOCIATION WITH ENDOSCOPY FINDINGS
Abstract: In the last decades,
the incidence of esophageal adenocarcinoma has significantly increased. Barrett
Esophagus (BE) is widely known as a precursor lession of esophageal
adenocarcinoma, and it could increase the risk of adenocarcinoma to 30-120
times higher than non-BE patient. The controversy about BE definition is still
a problem amongst pathologist. BE is defined as the transition of normal
esophageal squamous epithellium into metaplastic columnar epithellium that can
be seen through endoscopy at the upper region of gastroesophagus transitional
area, and confirmed with hystological examination.
Objective : To re-evaluate hystopathological presentation of BE and the
classification of dysplasia as well as its association with clinical finding in
the form of endoscopy results.
Methods : Clinical and hystopathological datas of 71 cases of BE was
collected and re-evaluated based on British Society of Gastroenterology
Guidelines 2005 criteria, as well as re-evaluating the grade of dysplasia based
on WHO Classification of tumours of the digestive system 2010.
Results : 51 cases of BE were obtained with male:female ratio 33:18
patients. BE cases were predominated by 51-60 years old age group, in which the
mean of patients age was 55 years old. The results of dysplasia grade
re-evaluation showed 72,55% non-dysplasia BE case, 3,9% was BE indefinite; 23,53%
was BE with low grade dysplasia; and 1,97% was BE with hard grade dysplasia.
There were 15 cases (21,12%) that were changed in diagnosis, from BE to non-BE
cases.
Conclusion : The diagnosis of BE could be made if there are compatibility
between endoscopy examination and hystopathological examination, in which BE
presentations was found, either in category 1, 2 or 3based on British Society
of Gastroenterology Guidelines 2005 and endoscopy indicated supicion of BE.
Changes in diagnosis of BE cases into non-BE cases could happen not because
there are incompatibilities of the results of these examinations. This might
happen due to nescience regarding the importance of the results of endoscopy
examination and its compatibility with the results of hystopathological
examination.
Keywords: acute pulmonary
edema chronic kidney disease kerley line
Author: Ukhti Jamil
Rustiasari, Handjari DR
Journal Code: jpkedokterangg170264
