GASTROENTEROLOGY ARTICLE OF THE WEEK
April 23, 2009
Odze RD. How to manage a Barrett’s esophagus patient with low grade dysplasia. Clin Gastroenterol Hepatol 2009;7:27-32
1. Over a period of 5 years, patients what percent of patients with documented low grade dysplasia will progress to adenocarcinoma according to prospective studies?
a. 50%
b. 30%
c. 10%
d. 5%
e. 3%
f. 0.05%
2. A 53 y/o man with BE has LGD on flat mucosa confirmed by two pathologists on biopsies obtained 6 months ago and again last week. His next endoscopy test should be:
a. in 3 months
b. in 6 months
c. in 12 months
d. in 2 years
e. should go to EMR now
f. in 3 years
True or False
2. Surveillance biopsies should not be obtained if endoscopic esophagitis is present
3. All patients with mucosal abnormalities should undergo EMR regardless of the results of pinch biopsy samples
4. In patients with low grade dysplasia, the annual rate of progression to adenocarcinoma is similar to that of non-dysplastic Barrett’s.
5. A patient with low grade dysplasia should undergo repeat EGD within 6 months and biopsies obtained from all quandrants every 1cm
6. Proton pump inhibitors reduce the risk of dysplasia in BE
7. Mucosal ablation is an accepted therapy for low grade dysplasia