Abstract:
BACKGROUND AND AIMS:Endoscopic resection is the cornerstone of treatment of Barrett's esophagus (BE)-related neoplasia. However, accurate histopathologic evaluation of endoscopic resection specimens can be challenging, and the preferred specimen handling method remains unknown. Therefore, the aim of our study was to compare 3 different specimen handling methods for assessment of all clinically relevant histopathologic parameters and time required for specimen handling. METHODS:In this multicenter, randomized study EMR specimens of BE-related neoplasia with no suspicion of submucosal invasion during endoscopy were randomized to 3 specimen handling methods: pinning on paraffin using needles, direct fixation in formalin without prior tissue handling, and the cassette technique (small box for enclosing specimens). The histopathologic evaluation scores were assessed by 2 dedicated GI pathologists blinded to the handling method. RESULTS:Of the 126 randomized EMR specimens, 45 were assigned to pinning on paraffin, 41 to direct fixation in formalin, and 40 to the cassette technique. The percentages of specimens with overall optimal histopathologic evaluation scores were similar for the pinning method (98%; 95% confidence interval [CI], 88.0-99.9) and for no handling (90%; 95% CI, 76.9-97.3) but were significantly lower (64%; 95% CI, 47.2-78.8) for the cassette technique (P < .001). Time required for specimen handling was shortest when no handling method was used (P < .001 vs pinning and cassette). CONCLUSIONS:Both pinning on paraffin and direct fixation in formalin resulted in optimal histopathologic evaluation scores in a high proportion of specimens, whereas the cassette technique performs significantly worse, and its use in clinical daily practice should be discouraged. Given the significantly shorter handling time, direct fixation in formalin appears to be the preferred method over pinning on paraffin. However, the latter needs to be confirmed in larger studies with inclusion of all EMR specimens. (Clinical trial registration number: ISRCTN50525266.).
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Overwater A,van der Meulen KE,Künzli HT,Schoon EJ,Bergman JJGHM,Mihaela Raicu G,Seldenrijk KCA,Weusten BLAMdoi
10.1016/j.gie.2019.03.014subject
Has Abstractpub_date
2019-09-01 00:00:00pages
384-392.e5issue
3eissn
0016-5107issn
1097-6779pii
S0016-5107(19)30176-2journal_volume
90pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Neoadjuvant chemoradiotherapy followed by surgery is the primary treatment option for patients with locally advanced esophageal cancer. This multicenter phase I trial examined intratumoral injection of TNFerade biologic, an adenoviral vector that expresses the human tumor necrosis factor-α gene, with chemora...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2012.01.042
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Stricture formation is the leading cause of long-term morbidity after photodynamic therapy (PDT). Risk factors for stricture formation have not been studied. OBJECTIVE:To assess risk factors for stricture formation in patients undergoing PDT for Barrett's esophagus with high-grade dysplasia (HGD). DESIGN:R...
journal_title:Gastrointestinal endoscopy
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abstract:BACKGROUND:A recent American Society for Gastrointestinal Endoscopy Technology Status Evaluation Report recommended comparative studies of water-aided colonoscopy methods to refine the optimal insertion technique. OBJECTIVE:Air insufflation (AI), water immersion (WI), and water exchange (WE) were compared head-to-head...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2014.07.029
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND AND AIMS:EUS-guided through-the-needle biopsy (TTNB) sampling has been reported to improve diagnostic yield compared with cytology for the evaluation of pancreatic cystic lesions (PCLs). The number of macroscopically visible tissue samples needed to reach an adequate diagnosis is still unknown. METHODS:This...
journal_title:Gastrointestinal endoscopy
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doi:10.1016/j.gie.2019.05.009
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abstract::Endoscopic ultrasonography was pre-operatively performed in 164 patients with colorectal cancer, and the resected specimens confirmed to be cancerous histologically. Normal colorectal wall was visualized by endoscopic ultrasonography as a five-layered structure. The first, third, and fifth layers were hyperechoic, and...
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
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abstract:BACKGROUND:More than 200,000 new cases of kidney cancer are diagnosed annually. The reported incidence of inferior vena cava (IVC) involvement in patients with renal-cell carcinoma (RCC) ranges from 4% to 10%. Standard imaging modalities are unable to distinguish the inner structure of a thrombus and whether the vessel...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.12.042
更新日期:2007-07-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01569-x
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Common bile duct stenosis occurs in up to 30% of patients with chronic pancreatitis. Most such stenoses are found incidentally during ERCP, but others manifest as obstructive jaundice, recurrent cholangitis, secondary biliary cirrhosis, or choledocholithiasis. Operative drainage has been the main treatment d...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02275-8
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Autoimmune pancreatitis has been designated as sclerosing pancreatocholangitis, because this disease shows a high prevalence of bile-duct lesions. We present herein the clinical characteristics of unusual cases that show dominant bile-duct lesions and mimicking infiltrating hilar cholangiocarcinomas. METHOD...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)00561-4
更新日期:2005-07-01 00:00:00
abstract::Malignant obstruction of the pancreaticobiliary system is a frequent indication for ERCP. Twenty-five patients with abnormalities suggestive of malignancy were encountered during ERCP at our institution and brush cytology was obtained. Positive cytology specimens were collected in 12 of 20 (60%) cases of malignancy ca...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71024-3
更新日期:1990-05-01 00:00:00
abstract::We investigated the endoscopic and histologic features of 74 nonpolypoid neoplasias of the colorectum measuring 15 mm or less in diameter. Colonoscopically, they were characterized by flat growth, being either slightly elevated with a central depression or else completely flat against the surrounding mucosa. Of the 54...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)80595-4
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Celiac ganglia have not been previously identified by EUS. OBJECTIVE:To assess whether celiac ganglia can be detected by EUS and to define their characteristics. DESIGN:Retrospective review followed by prospective study. METHODS:Retrospective characterization was performed of all celiac ganglia that were ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.01.071
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:EMR for the treatment of duodenal adenomas is challenging due to a thin wall and rich vascularity. OBJECTIVE:To evaluate a novel technique of "underwater" EMR without prior submucosal injection for the removal of large (≥2 cm) laterally spreading nonampullary duodenal adenomas. DESIGN:Prospective, observat...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.03.1330
更新日期:2013-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.07.049
更新日期:2006-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.128133
更新日期:2002-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1067/mge.2001.118256
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Biliary complications are the second leading cause of morbidity and mortality in orthotopic liver transplant (OLT) recipients. Endoscopic retrograde cholangiography (ERC) is considered the diagnostic criterion standard for post-orthotopic liver transplantation biliary obstruction, but incurs significant risk...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
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更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:It has been reported that the occurrence of acute cholangitis is common, especially when the self-expanding metal stent (SEMS) is placed across the main duodenal papilla. OBJECTIVE:To determine the incidence of duodenobiliary reflux and acute cholangitis after placement of SEMSs across the main duodenal pap...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.12.054
更新日期:2009-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.gie.2005.09.035
更新日期:2006-02-01 00:00:00
abstract::We evaluated a computerized report-generating system using voice recognition technology (EndoSpeak) for producing therapeutic ERCP reports. For 30 consecutive ERCP cases, reports using both EndoSpeak and standard dictation were generated at the end of the procedure. The cases were scored for overall difficulty and the...
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:1990-03-01 00:00:00
abstract::Patients with carcinoma of the head of the pancreas will develop obstructive jaundice at some point in their course in 80% to 90% of the cases. Surgical biliary digestive anastomosis carries a high 30-day mortality (20%), and hospitalization may be prolonged for several weeks owing to postoperative morbidity. We attem...
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pub_type: 杂志文章
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更新日期:1986-10-01 00:00:00