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Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study
摘要： Endoscopic features of early neoplasia in Barrett’s esophagus (BE) are subtle. Blue-light imaging (BLI) may improve visualization of neoplastic lesions. The aim of this study was to evaluate BLI in visualization of Barrett’s neoplasia. Methods: Corresponding white-light endoscopy (WLE) and BLI images of 40 BE lesions were obtained prospectively and assessed by 6 international experts in 3 assessments. Each assessment consisted of overview and magnification images. Assessments were as follows: assessment 1, WLE only; assessment 2, BLI only; and assessment 3, corresponding WLE and BLI images. Outcome parameters were as follows: (1) appreciation of macroscopic appearance and surface relief (visual analog scale scores); (2) ability to delineate lesions (visual analog scale scores); (3) preferred technique for delineation (ordinal scores); and (4) quantitative agreement on delineations (AND/OR scores). Results: Experts appreciated BLI significantly better than WLE for visualization of macroscopic appearance (median 8.0 vs 7.0, P < .001) and surface relief (8.0 vs 6.0, P < .001). For both overview and magnification images, experts appreciated BLI significantly better than WLE for ability to delineate lesions (8.0 vs 6.0, P < .001 and 8.0 vs 5.0, P < .001). There was no overall significant difference in AND/OR scores of WLE + BLI when compared with WLE, yet agreement increased significantly with WLE + BLI for cases with a low baseline AND/OR score on WLE, both in overview (mean difference, 0.15; P = .015) and magnification (mean difference, 0.10; P = .01). Conclusions: BLI has additional value for visualization of BE neoplasia. Experts appreciated BLI better than WLE for visualization and delineation of BE neoplasia. Quantitative agreement increased significantly when BLI was offered next to WLE for lesions that were hard to delineate with WLE alone.
关键词： neoplasia,white-light endoscopy,visualization,Barrett's esophagus,delineation,blue-light imaging
更新于2025-09-23 15:23:52
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Photodynamic therapy versus endoscopic submucosal dissection for management of patients with early esophageal neoplasia: a retrospective study
摘要： Background: Photodynamic therapy (PDT) and endoscopic submucosal dissection (ESD) have been proposed as a treatment for early esophageal neoplasia. The objective of this study is to compare between the clinical outcome after ESD and PDT to reach the best management for early esophageal neoplasia. Methods: All patients undergoing ESD or PDT for early esophageal neoplasia between 2014 and 2015 were eligible for the study. A retrospective analysis for comparison between the results of ESD and PDT was done. Results: 36 patients underwent ESD and Thirty PDT. No significant difference was found between the two groups regarding the demographic or pathologic data. Also, there was no significant difference regarding the length of hospital stay, presence of hydrothorax, fever, and pain. Operative time was significantly longer in ESD than in PDT (72 vs. 8 minutes, P<0.001). In addition, bleeding was significantly lower in ESD than PDT (12 vs. 2, P<0.05). There was a significant difference regarding stricture and cost which were less in ESD (6 vs. 15, P<0.05). However, perforation was much more in ESD (6 vs. 0, P<0.05). There was no significant difference between the two groups regarding the disease free survival (DFS), but it was observed that patients who underwent PDT had more favorable 2-year DFS rates than patients received ESD. Conclusions: The PDT may be comparable to the ESD. With the exception of esophageal stenosis, PDT could reduce many complications and have longer DFS in comparison with ESD. PDT is feasible for patients with early esophageal neoplasia confined to the mucosal layer without regional lymph nodal or distant metastasis.
关键词： Photodynamic therapy (PDT),early esophageal neoplasia,endoscopic submucosal dissection (ESD)
更新于2025-09-23 15:23:52
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Raman-Enhanced Spectroscopy (RESpect) Distinguishes Anal Squamous Intraepithelial Lesions in HIV-Serodiscordant Couples
摘要： HIV-positive individuals are at increased risk for pre-cancerous anal squamous intraepithelial lesions (SILs). Anal cytology and digital rectal examination are performed as screening tools but extensive training and appropriate instruments are required to follow-up on an abnormal anal cytology. Thus novel approaches to SIL evaluation could improve better healthcare follow up by efficient and timely diagnosis to offer treatment options. Recently, Raman-enhanced spectroscopy (RESpect) has emerged as a potential new tool for early identification of SIL. RESpect is a non-invasive, label-free, laser-based technique that identifies molecular composition of tissues and cells. HIV-serodiscordant couples had anal biopsies obtained during high resolution anoscopy. RESpect was performed on the specimens. Principal Component Analysis of the data identified differences between normal and abnormal tissue as well as HIV-positive and HIV-negative individuals of each couple even with similar pathologies. RESpect has the potential to change the paradigm of anal pathology diagnosis and could provide insight into different pathways leading to SIL in HIV-serodiscordant couples.
关键词： Anal Neoplasia,Raman Spectroscopy,HIV-Serodiscordant
更新于2025-09-23 15:23:52