L. Minelli

HER-2 overexpression/amplification in Barrett's oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study.

Barrett’s oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia‐dysplasia‐carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin‐embedded tissue. The end‐points were the occurrence of progression and the time‐to‐progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37–84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation.

Endoscopic Therapy for Esophageal Varices

Among therapeutic endoscopic options for esophageal varices (EV), endoscopic variceal ligation (EVL) has proven more effectiveness and safety compared with endoscopic sclerotherapy and is currently co

P.1.167: ROLE OF SMALL BOWEL CAPSULE ENDOSCOPY IN PATIENTS WITH HEREDITARY INTESTINAL POLYPOSIS: A SINGLE CENTER EXPERIENCE

22.4% required additional argon-plasma-coagulation. Due to size ( 4 mm), 5.1% were treated by forceps biopsy and additional APC-therapy. Local recurrence developed in 42.3% and was retreated endoscopically. Only one major complication (single perforation) was recorded. Minor complications (14.2%) consisted in either immediate bleeding after resection or bleeding up to 48 h after endoscopic therapy. All complications could be managed endoscopically.Endoscopic mucosal resection, if necessary combined with argonplasma-coagulation, represents an efficient and acceptably safe technique for treating duodenal adenomata. However, in comparison with colonic polypectomy, local recurrence and complications are more common. Follow-up endoscopy is recommended in short intervals such as 3 months. As relevant bleeding can occur up to 48 hours after resection, patients are in need of close monitoring. EMR should therefore not be performed in an outpatient setting.

Lower Gastrointestinal Endoscopy For Polyps and Polyposis

Colonoscopy has become the leading method to explore the entire colon, and is currently considered the gold standard for colorectal cancer screening. Improvements in technology have provided specific diagnostic capability, and the treatment of dysplastic and neoplastic superficial lesions is now achievable in the majority of patients, by adopting sophisticated resection techniques. Endoscopic treatment of polyps must be performed in order to both minimize the risks of the procedure and optimize the completeness of the removal, thereby reducing recurrence; therefore operators must be skilled and continuously trained, in order to perform local treatment by either endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). In this way, endoscopic resection can be considered a safe and effective alternative to surgery for the treatment of colorectal polyps.