How Often Does Endoscopic Ablation Result in Buried Metaplasia?

A review found wide disparity in estimated frequencies of this condition, as well as insufficient biopsy sampling, leaving the question open.

During endoscopic ablation of Barrett epithelium, if the entire metaplastic epithelium (with or without dysplasia) is not destroyed, then metaplastic glands in the lamina propria can become buried in the neosquamous epithelium and hidden from endoscopic view. However, the frequency of such “buried metaplasia” is unknown, and its potential for malignancy is controversial.

To investigate this issue, the authors conducted a systematic review of studies pertaining to the frequency of buried metaplasia after photodynamic therapy (PDT) or radiofrequency ablation (RFA) of Barrett esophagus, as detected through biopsy sampling of the neosquamous epithelium.

In 18 studies of 1004 patients who received RFA, investigators observed buried metaplasia in 9…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors