How useful is histologic confirmation of intestinal metaplasia in patients with long-segment Barrett's esophagus?
Chin Hur* and Patrick Yachimski
Correspondence *Massachusetts General, Hospital, Gastrointestinal Unit & the, Institute for Technology, Assessment, 101 Merrimac Street, Boston, MA 02114, USA
Email chur@partners.org
This article has no abstract so we have provided the first paragraph of the full text.
Although population prevalence data are limited, more than 3 million individuals in the US are estimated to harbor Barrett's esophagus.1 American consensus criteria for the diagnosis of Barrett's esophagus require biopsy-proven intestinal metaplasia,2 although this viewpoint is not universally endorsed.3 Agreement exists that intestinal metaplasia is a precursor to esophageal adenocarcinoma; however, much of the rationale for not requiring evidence of intestinal metaplasia to diagnose Barrett's esophagus centers on the relatively high error rate of biopsy for detecting intestinal metaplasia within columnar-lined epithelium. The high false-negative rate of biopsy means that Barrett's esophagus can be missed in some patients if the stringent diagnostic requirement of histologic evidence of intestinal metaplasia is not met. This concern might be further heightened in health-care settings where logistical constraints limit the number of biopsies that can be obtained during endoscopic examinations.
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