BOB CAT: A Large-Scale Review and Delphi Consensus for Management of Barrett's Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

被引：107

作者：

Bennett, Cathy ^{[1
]}

Moayyedi, Paul ^{[2
]}

Corley, Douglas A. ^{[3
]}

DeCaestecker, John ^{[4
]}

Falck-Ytter, Yngve ^{[5
]}

Falk, Gary ^{[6
]}

Vakil, Nimish ^{[7
]}

Sanders, Scott ^{[8
]}

Vieth, Michael ^{[9
]}

Inadomi, John ^{[10
]}

Aldulaimi, David ^{[11
]}

Ho, Khek-Yu ^{[12
]}

Odze, Robert ^{[13
]}

Meltzer, Stephen J. ^{[14
]}

Quigley, Eamonn ^{[15
,16
]}

Gittens, Stuart ^{[17
]}

Watson, Peter ^{[18
]}

Zaninotto, Giovanni ^{[19
]}

Iyer, Prasad G. ^{[20
]}

Alexandre, Leo ^{[21
]}

Ang, Yeng ^{[22
]}

Callaghan, James ^{[23
]}

Harrison, Rebecca ^{[4
]}

Singh, Rajvinder ^{[24
]}

Bhandari, Pradeep ^{[25
]}

Bisschops, Raf ^{[26
]}

Geramizadeh, Bita ^{[27
]}

Kaye, Philip ^{[28
]}

Krishnadath, Sheila ^{[29
]}

Fennerty, M. Brian ^{[30
]}

Manner, Hendrik ^{[31
]}

Nason, Katie S. ^{[32
]}

Pech, Oliver ^{[33
]}

Konda, Vani ^{[34
]}

Ragunath, Krish ^{[35
]}

Rahman, Imdadur ^{[36
]}

Romero, Yvonne ^{[20
]}

Sampliner, Richard ^{[37
]}

Siersema, Peter D. ^{[38
]}

Tack, Jan ^{[39
]}

Tham, Tony C. K. ^{[40
]}

Trudgill, Nigel ^{[41
]}

Weinberg, David S. ^{[42
]}

Wang, Jean ^{[43
]}

Wang, Kenneth ^{[20
]}

Wong, Jennie Y. Y. ^{[44
]}

Attwood, Stephen ^{[45
]}

Malfertheiner, Peter ^{[46
]}

MacDonald, David ^{[47
]}

Barr, Hugh ^{[48
]}

机构：

[1] Coventry Univ, Ctr Technol Enabled Hlth Res, Coventry, W Midlands, England

[2] McMaster Univ, Hamilton, ON, Canada

[3] Kaiser Permanente, Oakland, CA USA

[4] Leicester Gen Hosp, Leicester LE5 4PW, Leics, England

[5] Case Western Reserve Univ, Sch Med, Case & VA Med Ctr Cleveland, Cleveland, OH USA

[6] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA

[7] Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI USA

[8] NHS Fdn Trust, Warwick, England

[9] Klinikum Bayreuth, Bayreuth, Germany

[10] Univ Washington, Sch Med, Seattle, WA USA

[11] Worcestershire Acute Hosp NHS Trust, Redditch, Worcs, England

[12] Natl Univ Hlth Syst, Singapore, Singapore

[13] Brigham & Womens Hosp, Boston, MA 02115 USA

[14] Johns Hopkins Sch Med, Baltimore, MD USA

[15] Weill Cornell Med Coll, Houston, TX USA

[16] Houston Methodist Hosp, Houston, TX USA

[17] ECD Solut, Columbus, OH USA

[18] Queens Univ Belfast, Belfast, Antrim, North Ireland

[19] St Marys Hosp, Univ London Imperial Coll Sci Technol & Med, London, England

[20] Mayo Clin, Rochester, MI USA

[21] Univ E Anglia, Norwich Med Sch, Norwich NR4 7TJ, Norfolk, England

[22] Univ Manchester, Manchester, Lancs, England

[23] Southampton Univ Hosp, Dept Gastroenterol, Southampton, Hants, England

[24] Univ Adelaide, Lyell McEwin Hosp, Adelaide, SA, Australia

[25] Queen Alexandra Hosp, Portsmouth, Hants, England

[26] Univ Hosp Leuven, Leuven, Belgium

[27] Shiraz Univ Med Sci, Transplant Res Ctr, Dept Pathol, Shiraz, Iran

[28] Nottingham Univ Hosp NHS Trust, Nottingham, England

[29] AMC, Gastrointestinal Oncol Res Grp, Amsterdam, Netherlands

[30] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[31] HSK Wiesbaden, Dept Gastroenterol, Wiesbaden, Germany

[32] Univ Pittsburgh, Pittsburgh, PA USA

[33] Krankenhaus Barmherzige Brueder, Regensburg, Germany

[34] Univ Chicago, Chicago, IL 60637 USA

[35] Univ Nottingham, Queens Med Ctr, Nottingham NG7 2RD, England

[36] Southampton Univ Hosp, Southampton, Hants, England

[37] Univ Arizona, Ctr Canc, Tucson, AZ USA

[38] Univ Med Ctr Utrecht, Utrecht, Netherlands

[39] Univ Leuven, Leuven, Belgium

[40] Ulster Hosp, Belfast, Antrim, North Ireland

[41] Sandwell & West Birmingham Hosp NHS Trust, West Bromwich, W Midlands, England

[42] Fox Chase Canc Ctr, Philadelphia, PA 19111 USA

[43] Washington Univ, Sch Med, St Louis, MO USA

[44] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore 117595, Singapore

[45] Univ Durham, Durham, England

[46] Univ Magdeburg, D-39106 Magdeburg, Germany

[47] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada

[48] Gloucestershire Royal Hosp, Gloucester GL1 3NN, England

[49] Univ Chicago Med, Chicago, IL USA

[50] Univ Hosp Coventry & Warwickshire, Coventry, W Midlands, England

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2015年 / 110卷 / 05期

基金：

美国国家卫生研究院;

关键词：

GASTROESOPHAGEAL-REFLUX DISEASE; PROTON PUMP INHIBITORS; ENDOSCOPIC MUCOSAL RESECTION; TERM-FOLLOW-UP; ARGON PLASMA COAGULATION; COLUMNAR-LINED ESOPHAGUS; RADIOFREQUENCY ABLATION; INTESTINAL METAPLASIA; NEOPLASTIC PROGRESSION; ANTIREFLUX SURGERY;

D O I：

10.1038/ajg.2015.55

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS: We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS: In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for <5 years of life expectancy. Management strategies for indefinite dysplasia (IND) and LGD were identified, including a de-escalation strategy for lower-risk patients and escalation to intervention with follow-up for higher-risk patients. CONCLUSIONS: In this uniquely large consensus process in gastroenterology, we made key clinical recommendations for the escalation/de-escalation of BE in clinical practice. We made strong recommendations for the prioritization of future research.

引用

页码：662 / 682

页数：21

共 184 条

[1] Dysplasia detection rate of confirmatory EGD in nondysplastic Barrett's esophagus [J].

Abdalla, M. ;

Dhanekula, R. ;

Greenspan, M. ;

Mobarhan, S. ;

Patil, A. ;

Jakate, S. ;

Giusto, D. ;

Silva, R. ;

Li, H. ;

Melson, J. .

DISEASES OF THE ESOPHAGUS, 2014, 27 (06) :505-510

[2] Adherence to Biopsy Guidelines for Barrett's Esophagus Surveillance in the Community Setting in the United States [J].

Abrams, Julian A. ;

Kapel, Robert C. ;

Lindberg, Guy M. ;

Saboorian, Mohammad H. ;

Genta, Robert M. ;

Neugut, Alfred I. ;

Lightdale, Charles J. .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2009, 7 (07) :736-742

[3] Barrett's surveillance is worthwhile and detects curable cancers. A prospective cohort study addressing cancer incidence, treatment outcome and survival [J].

Aldulaimi, DM ;

Cox, M ;

Nwokolo, CU ;

Loft, DE .

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2005, 17 (09) :943-950

[4] Meta-analysis of endoscopic therapy for low-grade dysplasia in Barrett's oesophagus [J].

Almond, L. M. ;

Hodson, J. ;

Barr, H. .

BRITISH JOURNAL OF SURGERY, 2014, 101 (10) :1187-1195

[5] Barrett's esophagus specialist clinic: what difference can it make? [J].

Anagnostopoulos, GK ;

Pick, B ;

Cunliffe, R ;

Fortun, P ;

Kaye, P ;

Ragunath, K .

DISEASES OF THE ESOPHAGUS, 2006, 19 (02) :84-87

[6] Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia [J].

Anandasabapathy, Sharmila ;

Jhamb, Jagriti ;

Davila, Marta ;

Wei, Caimiao ;

Morris, Jeffrey ;

Bresalier, Robert .

CANCER, 2007, 109 (04) :668-674

[7] Mortality in Barrett's oesophagus: results from a population based study [J].

Anderson, LA ;

Murray, LJ ;

Murphy, SJ ;

Fitzpatrick, DA ;

Johnston, BT ;

Watson, RGP ;

McCarron, P ;

Gavin, AT .

GUT, 2003, 52 (08) :1081-1084

[8]

[Anonymous], 2008, AM J GASTROENTEROL, V103, P850, DOI 10.1111/j.1572-0241.2007.01746.x

[9]

[Anonymous], DIS ESOPHAGUS

[10]

[Anonymous], R COLL PATHOL

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