GI Studies Focus on Barrett's Esophagus, Endoscopic Ultrasound

Three studies in the November issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy, highlighted new findings related to asymptomatic women with Barrett's esophagus, the accuracy of endoscopic ultrasound-fine needle aspiration in pancreatic endocrine tumors and the use of EUS and EUS-FNA in pediatric patients, according to an ASGE news release.

In the first study, researchers from Stanford University and Palo Alto VA Health Care System in California performed a prospective study to determine the prevalence of Barrett's esophagus in asymptomatic women undergoing routine screening colonoscopy or endoscopic examination before bariatric surgery. According to the release, short-segment Barrett's esophagus was detected in 6 percent of 126 asymptomatic women undergoing these procedures. Patients found to have Barrett's esophagus were more likely to be 61-70 years of age, but there was no difference in mean body mass index, ethnicity or tobacco or alcohol use between patients with and without Barrett's esophagus. Barrett's esophagus was most commonly detected in the under 50 age group in pre-bariatric surgery patients, which could support an increased risk of Barrett's esophagus in obese patients, as previously reported.

Barrett's esophagus is often associated with gastroesophageal reflux disease and can often indicate an increased risk of esophageal cancer.

In the second study, researchers observed a single-center, retrospective cohort of 86 patients who had been diagnosed with pancreatic endocrine tumors and submitted to EUS-FNA from Jan. 1999-Aug. 2008. According to the release, EUS consists of a flexible endoscope which has a small ultrasound device built into the end. In EUS-FNA, tissue samples are collected using a fine needle aspiration technique.

In 90 percent of patients in this study, PET was diagnosed with EUS-FNA, and sensitivity did not vary with tumor size, type, location or the presence of hormonal secretion, according to the release. The five-year survival rates were 100 percent for endocrine tumors, 68 percent for well-differentiated endocrine carcinomas and 30 percent for poorly differentiated endocrine carcinomas. Therefore, the researchers concluded that it was possible and safe to diagnose PET and to determine potential malignant behavior using specimens obtained by EUS-FNA and applying WHO classification.

In the final study, researchers reviewed all EUS procedures performed from Sept. 2001-Sept. 2008 at Oregon Health & Science University in Portland, Ore., and University of Utah School of Medicine in Salt Lake City, Utah, and patients younger than 18 years of age were identified. Over the seven-year period, 40 of 6,724 EUS procedures were performed on 38 patients younger than 18 years of age, according to the release. The procedure was successful in all patients and no complications related to sedation, EUS or EUS-FNA was encountered. The study also found that standard adult EUS equipment and accessories could be used in all patients to successfully perform procedures in children three years of age or older. Disorders of the pancreatobiliary system were the primary indication in the majority of the study cases (62.5 percent. Researchers concluded that EUS and EUS-FNA are feasible and safe and have a significant impact on the management of pediatric GI, pancreatobiliary and mediastinal (area of the chest between the lungs) diseases.

Read the release about the new gastroenterology studies (pdf).