Anandasabapathy et al reported clinical and endoscopic findings associated with high grade dysplasia in a patient with Barrett's esophagus. These can help to identify a patient who may require more aggressive management. The authors are from the University of Texas M.D. Anderson Cancer Center.
Patient selection: Barrett's esophagus
Risk factors for high grade dysplasia"
(1) male sex (odds ratio 4.0)
(2) duration of gastroesophageal reflux disease (GERD; odds ratio 5.7 if >= 20 years and 3.3 if 6 to 19 years; as a continuous variable the odds ratio was 1.05 per year)
(3) size of a hiatal hernia (odds ratio 10.6 if >= 4 cm and 3.9 if < 4 versus no hernia)
(4) segment length of the Barrett's disease (odds ratio 8.4 for >= 6 cm and 9.1 for 3-5 cm; as a continuous variable the odds ratio was 1.333 per cm)
The risk of high-grade dysplasia increased with the number of risk factors present.
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