Endoscopic fluorescence detection of high-grade dysplasia in Barrett's esophagus.


Journal Article

BACKGROUND & AIMS:Early detection and treatment of esophageal cancer in Barrett's esophagus may improve patient survival if dysplasia is effectively detected at endoscopy. Typically, four-quadrant pinch biopsy specimens are taken at 2-cm intervals. This study was conducted to determine whether laser-induced fluorescence spectroscopy could be used to detect high-grade dysplasia in patients with Barrett's esophagus. METHODS:Four hundred ten-naonometer laser light was used to induce autofluorescence of Barrett's mucosa in 36 patients. The spectra were analyzed using the differential normalized fluorescence (DNF) index technique to differentiate high-grade dysplasia from either low-grade or nondysplastic mucosa. Each spectrum was classified as either premalignant or benign using two different DNF indices. RESULTS:Analysis of the fluorescence spectra from all patients collectively using the DNF intensity at 480 nm (DNF480) index showed that 96% of nondysplastic Barrett's esophagus samples were classified as benign, all low-grade dysplasia samples as benign, 90% of high-grade dysplasia samples as premalignant, and 28% of low-grade with focal high-grade dysplasia samples as premalignant. Using the two DNF indices concurrently, all patients with any high-grade dysplasia were classified correctly. CONCLUSIONS:Laser-induced fluorescence spectroscopy has great potential to detect high-grade dysplasia in Barrett's esophagus when using the DNF technique.

Full Text

Duke Authors

Cited Authors

  • Panjehpour, M; Overholt, BF; Vo-Dinh, T; Haggitt, RC; Edwards, DH; Buckley, FP

Published Date

  • July 1996

Published In

Volume / Issue

  • 111 / 1

Start / End Page

  • 93 - 101

PubMed ID

  • 8698231

Pubmed Central ID

  • 8698231

Electronic International Standard Serial Number (EISSN)

  • 1528-0012

International Standard Serial Number (ISSN)

  • 0016-5085

Digital Object Identifier (DOI)

  • 10.1053/gast.1996.v111.pm8698231


  • eng