Clinical, endoscopic and pathological features of early Barrett esophageal adenocarcinoma and its treatment efficacy by endoscopic submucosal dissection

Abstract

Objective To investigate the clinical, endoscopic and pathological characteristics of early Barrett esophageal adenocarcinoma (BEA) and to evaluate the treatment efficacy of endoscopic submucosal dissection (ESD). Methods Data of 13 patients who were diagnosed as early BEA and treated by ESD in Beijing Friendship Hospital from November 2015 to June 2018 were retrospectively analyzed, including clinical data, endoscopic manifestations and pathological information. Results Out of 13 patients, 10 were male. One had underlying long-segment Barrett esophagus (LSBE), 6 had short-segment Barrett esophagus (SSBE), and 6 had super short-segment Barrett esophagus (less than 1 cm). Two arose from circumferential Barrett esophageal (BE) and 11 from tongue-like BE. Ten lesions were located on the right anterior side wall (12-2 o′clock) of the esophagogastric junction (EGJ), and 12 lesions were superficial type (0-Ⅱ). ESD was successfully conducted in all the patients without any complication. The en bloc and curative resection rate was 100% (13/13) and 92% (12/13), respectively. Pathology examination found 9 well-differentiated adenocarcinoma and 10 intramucosal cancer. No recurrence was detected in 11 patients during follow-up of 3.3-29.3 months. Conclusion Early BEA tends to occur in elderly male, and mostly originated from non-LSBE and tongue-like BE. Most lesions are superficial type and located on the right anterior side wall of EGJ. In pathology, most lesions are well-differentiated adenocarcinoma and limited to the mucosa. ESD is a safe and efficient treatment for BEA. Key words: Barrett esophagus; Adenocarcinoma; Clinical feature; Endoscopic feature; Pathologic feature; Endoscopic submucosal dissection