Journal article
Multicenter randomized controlled trial comparing forceps biopsy sampling with wide-area transepithelial sampling brush for detecting intestinal metaplasia and dysplasia during routine upper endoscopy
Gastrointestinal endoscopy, v 95(6), pp 1101-1110.e2
Jun 2022
PMID: 34902373
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Intestinal metaplasia (IM) in the esophagus is a potentially premalignant mucosal change. The aim of this study was to compare the frequency of IM detection during upper endoscopy by forceps biopsy sampling (FB) versus wide-area transepithelial sampling (WATS) brush.
Patients presenting for upper endoscopy for foregut symptoms or surveillance of Barrett’s esophagus (BE) at 9 centers in the United States were randomized to either FB or WATS.
Of 1002 patients, FB was done in 505 and WATS in 497. The overall frequency of finding IM was 21% and was similar with FB (19.6%) and WATS (22.7%, P = .2). Low-grade dysplasia was found in 8 patients. No patient had high-grade dysplasia. There was no difference in detection of dysplasia between FB and WATS. In patients with no history of IM, WATS found significantly more IM compared with FB when a columnar-lined esophagus (CLE) was present (32.4% with WATS vs 15.2% with FB, P = .004). In 184 patients with known BE, FB and WATS found IM with similar frequency (38.5% FB vs 41.9% WATS, P = .6) with no difference in short- or long-segment BE.
Overall, FB and WATS detected a similar frequency of IM and dysplasia. WATS was twice as likely as FB to find IM in patients without a history of BE who had CLE on endoscopy. In patients with known BE, WATS and FB showed IM and dysplasia with similar frequency. These findings suggest that WATS can be used instead of FB with similar or improved efficacy at detecting IM and dysplasia. (Clinical trial registration number: NCT03859557.)
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Details
- Title
- Multicenter randomized controlled trial comparing forceps biopsy sampling with wide-area transepithelial sampling brush for detecting intestinal metaplasia and dysplasia during routine upper endoscopy
- Creators
- Steven DeMeester - Providence Portland Medical CenterChris Smith - Southern Reflux Center, Albany, Georgia, USAPaul Severson - Minnesota Reflux and Heartburn Center, Minneapolis, Minnesota, USAAndrew Loveitt - Minnesota Reflux and Heartburn Center, Minneapolis, Minnesota, USABlair Jobe - Allegheny Health NetworkPhilip Woodworth - Sisters of Mercy Health SystemDennis Wilcox - Mad River Community Hospital, Arcata, California, USAChristy Dunst - Providence Portland Medical CenterShahin AyaziRobert AlderholdPeter BillingJ. Price CorrJohn B. DavisEric HarrisJedediah KaufmanAshwin KurianElwood MartinHoward McCollisterBruce ParkerKevin ReavisKurtis StewartAngi GillRichard ScottRobert OdzeHawaii Esophageal Course Study Group
- Publication Details
- Gastrointestinal endoscopy, v 95(6), pp 1101-1110.e2
- Publisher
- Elsevier Inc; NEW YORK
- Number of pages
- 12
- Grant note
- CDx Diagnostics
All authors disclosed no financial relationships. Research support for this study was provided by a grant from CDx Diagnostics.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000803755400009
- Scopus ID
- 2-s2.0-85126274142
- Other Identifier
- 991022048288904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology