Endoscopy 2004; 36(9): 776-781
DOI: 10.1055/s-2004-825802
Original Article
© Georg Thieme Verlag Stuttgart · New York

Histological Analysis of Endoscopic Resection Specimens From 326 Patients with Barrett’s Esophagus and Early Neoplasia

M.  Vieth1 , C.  Ell2 , L.  Gossner2 , A.  May2 , M.  Stolte3
  • 1Institute of Pathology, Otto-von-Guericke University, Magdeburg, Germany
  • 2Second Department of Internal Medicine, HSK-Kliniken, Wiesbaden, Germany
  • 3Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
Further Information

Publication History

Submitted 15 July 2003

Accepted after Revision 15 June 2004

Publication Date:
24 August 2004 (online)

Background and Study Aims: Endoscopic resection has been recommended as a local curative approach for Barrett’s neoplasia, but large series are still rare. In the present study we analyzed the histological characteristics of endoscopic resection specimens of Barrett’s neoplasia.
Patients and Methods: 742 endoscopic resection specimens obtained from 326 patients were assessed. The following histological characteristics were evaluated: type of neoplasia, grade of differentiation, depth of infiltration, invasion into lymphatic and blood vessels, and resection status (tumor-free margins were regarded as indicating R0 status).
Results: 31 patients had no neoplasia and were excluded from the analysis. Among the remaining 295 patients (711 resection specimens), histological findings were: low-grade intraepithelial neoplasia, 1.0 %; high-grade intraepithelial neoplasia, 2.7 %; and mucosal carcinoma 80.3 %. Carcinomas infiltrating the submucosal layer were rare (sm1 7.5 %; sm2 3.7 %; sm3 4.8 %), as were those invading lymph vessels (3.5 %), and there were none with venous invasion. Most of the carcinomas were well-differentiated (72.2 %), and many of these (92.7 %) were limited to the mucosa, in contrast to moderately and poorly differentiated carcinomas (73.7 % and 22.7 %, respectively). R0 status was achieved in 74.5 % of patients; in 47.8 % this was after repeated endoscopic resection. In 26.8 % of patients, R0 resection was achieved at the first attempt.
Conclusions: Our study demonstrates that early Barrett’s neoplasms removed by endoscopic resection are mostly limited to the mucosa, are well to moderately differentiated, and very rarely show invasion of the lymph or blood vessels. Although these lesions seem to be low risk with regard to metastatic spread and therefore treatable endoscopically, improved endoscopic resection methods for achieving one-piece (en bloc) R0 resection should be developed.


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M. Stolte, M. D.

Institute of Pathology

Preuschwitzerstr. 101 · 95445 Bayreuth · Germany ·

Fax: +49-921-4005609

Email: michael.vieth@medizin.uni-magdeburg.de