Mo1901 Goblet-Cell Density and Differentiation in Barrett's Esophagus Correlate With Increased Esophageal-Adenocarcinoma Development in Humans

Abstract

on histopathology confirmed by two expert pathologists received a follow up EGD with biopsies within 1 year of the index endoscopy. The follow-up endoscopy and review of histopathology from targeted biopsies was carried out in the same manner as the index endoscopy. We examined multiple predictive variables (clinical, demographic and the endoscopist identity) and three possible outcomes (definite BE BE plus in targeted biopsies, endoscopic BE only BE with no SIM or no BE) on repeat EGD. Results: A total of 1844 patients underwent EGD; 344 had suspected BE on endoscopy including 237 with definite BE (146 (62%) short ,3 cm segment and 91 (38%) long segment). 107 patients had endoscopic only BE [101 (94%) short segment and 6 (6%) long segment)., 80 underwent a repeat EGD with biopsies within 1 year of the index EGD of which 96% were men with an age distribution of 40-49 (14%), 50-59 (26%), 60-69 (46%) and .70 years (14%). 70% (56 of 80 patients) had endoscopic BE confirmed at repeat EGD and 23 (29%) had biopsies confirming SIM. The mean length of BE on the index EGD was slightly longer among patients with definite BE than those with endoscopic only BE and no BE on the repeat EGD; 1.6 cm (SD 1.3), 1.5 cm (SD 1.4) and 1.4 cm (SD 1.2), respectively. The majority (96%) confirmed BE on repeat EGD had short segment BE ( ,3 cm). Patient gender, age, race, BMI, presence or duration of GERD symptoms or size of hiatal hernia were not significantly associated with a positive biopsy for BE on repeat EGD (p .0.1), and nor was the identity of the endoscopist. Conclusion: The majority of patients with endoscopic only BE had biopsies negative for on repeat EGD. The results of this study affirms the withholding of a diagnosis of BE for individuals with endoscopic only BE.