Department of Medicine, Division of Gastroenterology, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
Gastrointest Endosc. 2013 Sep;78(3):462-7. doi: 10.1016/j.gie.2013.03.167. Epub 2013 Apr 25.
Early cancer (high-grade dysplasia [HGD] and intramucosal carcinoma [ImCa]) associated with Barrett's esophagus (BE) may have a circumferential spatial predilection.
To describe the esophageal circumferential location of early cancer in BE.
Retrospective study, single tertiary referral center.
One hundred nineteen patients were referred for endoscopic eradication therapy for early cancer associated with BE. Endoscopic images and reports and pathology were reviewed.
Circumferential location designation of early cancer in BE by using a clock-face orientation.
One hundred nineteen of 131 patients referred for endoscopic eradication therapy had a location designation for their advanced histology (91.9%). There were a total of 57 patients (47.9%) with HGD and 62 patients (52.1%) with ImCa. There was a significantly higher rate of early cancer (HGD or ImCa) in the right hemisphere (12 to 6 o'clock location) compared with the left hemisphere (84.9% vs 15.1%, P < .0001). The highest percentage of early cancer was found in the 12 to 3 o'clock quadrant (64.7%); 71.9% of HGD and 58.1% of ImCa lesions were located in the 12 to 3 o'clock quadrant.
Retrospective design, single center.
Early cancer associated with BE is far more commonly found in the right hemisphere of the esophagus (12 to 6 o'clock) with the highest rate in the 12 to 3 o'clock quadrant. These findings support enhanced scrutiny of the right hemisphere of the esophagus during surveillance and endoscopic treatment of patients with BE.
与 Barrett 食管（BE）相关的早期癌症（高级别异型增生[HGD]和黏膜内癌[ImCa]）可能具有环形空间倾向。
描述 BE 中早期癌症的食管环形位置。
回顾性研究，单中心三级转诊中心。
119 例患者因与 BE 相关的早期癌症而被转介接受内镜下根治性治疗。回顾性分析内镜图像、报告和病理结果。
采用时钟面定向法对 BE 中早期癌症的环形位置进行指定。
131 例接受内镜下根治性治疗的患者中，有 119 例（91.9%）进行了高级别组织学的位置指定。共有 57 例（47.9%）HGD 和 62 例（52.1%）ImCa 患者。右半球（12 点至 6 点位置）早期癌症（HGD 或 ImCa）的发生率明显高于左半球（12 点至 6 点位置：84.9% vs 15.1%，P<0.0001）。发现早期癌症的最高百分比出现在 12 点至 3 点象限（64.7%）；71.9%的 HGD 和 58.1%的 ImCa 病变位于 12 点至 3 点象限。
回顾性设计，单中心。
与 BE 相关的早期癌症在食管的右半球（12 点至 6 点）更为常见，其中 12 点至 3 点象限的发生率最高。这些发现支持在 BE 患者的监测和内镜治疗中加强对食管右半球的仔细检查。
