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  • 1
    Language: English
    In: Gastrointestinal Endoscopy, December 2014, Vol.80(6), pp.1003-1004
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.gie.2014.09.021 Byline: Michael Vieth Author Affiliation: Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
    Keywords: Medicine
    ISSN: 0016-5107
    E-ISSN: 1097-6779
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  • 2
    Language: English
    In: Gut, 22 March 2013, Vol.62(3), p.358
    Description: Protein kinase C (PKC) signalling is often dysregulated in gastric cancer and therefore represents a potential target in cancer therapy. The Gram-negative bacterium , which colonises the human stomach, plays a major role in the development of gastritis, peptic ulcer and gastric adenocarcinoma.
    Keywords: AP-1 ; Caga ; C-Fos ; Marcks ; Plc ; Cell Signalling ; Adenocarcinoma ; Helicobacter Pylori ; Bacterial Infection ; Matrix Metalloproteinase ; Helicobacter Pylori—Pathogenesis ; Inflammation ; Nuclear Factor Kappa B ; Signal Transduction ; Molecular Oncology ; Gastro-Oesophageal Reflux Disease ; Barretts Metaplasia ; Barretts Carcinoma ; Gastro-Oesphageal Junction ; Mucosal Pathology ; Gastritis ; Gastric Inflammation ; Inflammatory Bowel Disease ; Gastrointestinal Cancer ; Gastric Neoplasia ; Gastric Pre-Cancer ; Open Access
    ISSN: 0017-5749
    ISSN: 00175749
    E-ISSN: 1468-3288
    E-ISSN: 14683288
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  • 3
    Article
    Article
    BMJ Publishing Group Ltd and British Society of Gastroenterology
    Language: English
    In: Gut, 31 February 2013, Vol.62(2), p.333
    Description: We read with interest the paper by Moussata et al and the GI snapshot by Neufert et al, published in recent issues of Gut.1 2 The authors described in these outstanding articles the potential of confocal laser endomicroscopy (CLE) to either image intramucosal bacteria in vivo in patients with inflammatory bowel diseases and also to visualise disease specific findings (‘foamy macrophages’) in a patient with Mycobacterium avium intracellulare infection.
    Keywords: Endoscopy
    ISSN: 0017-5749
    ISSN: 00175749
    E-ISSN: 1468-3288
    E-ISSN: 14683288
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  • 4
    Language: English
    In: Annals of the New York Academy of Sciences, Sept, 2011, Vol.1232, p.376(5)
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1749-6632.2011.06063.x Byline: Melissa P Upton (1), Rish K. Pai (2), Michael Vieth (3), Helmut Neumann (4), Cord Langner (5) Keywords: Barrett's esophagus; goblet cells; practice guidelines; stem cells; biopsy strategy; progression; dysplasia; early detection research network; aneuploidy; p53; metaplasia; bone marrow; cancer stimulating cells Abstract: The following on esophageal disease and pathology contains commentaries on the varied definitions of Barrett's esophagus (BE); the optimal biopsy strategy in BE; reliable biomarkers for progression to neoplasia in BE; and the role of bone marrow stem cells in the morphogenesis of Barrett's esophagus. Author Affiliation: (1)Rodger C. Haggitt Gastrointestinal and Hepatic Pathology Service, University of Washington, Seattle, Washington. (2)Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio. (3)Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany. (4)Medical Clinic I, University of Erlangen, Erlangen, Germany. (5)Institute of Pathology, Medical University Graz, Graz, Austria
    Keywords: Cancer Research ; Tumor Proteins ; Multiple Myeloma ; Dysplasia ; Stem Cells ; Stem Cell Research ; Barrett Esophagus
    ISSN: 0077-8923
    Source: Cengage Learning, Inc.
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  • 5
    Language: English
    In: Annals of the New York Academy of Sciences, Sept, 2011, Vol.1232, p.376(5)
    Description: To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1749-6632.2011.06063.x Byline: Melissa P Upton (1), Rish K. Pai (2), Michael Vieth (3), Helmut Neumann (4), Cord Langner (5) Keywords: Barrett's esophagus; goblet cells; practice guidelines; stem cells; biopsy strategy; progression; dysplasia; early detection research network; aneuploidy; p53; metaplasia; bone marrow; cancer stimulating cells Abstract: The following on esophageal disease and pathology contains commentaries on the varied definitions of Barrett's esophagus (BE); the optimal biopsy strategy in BE; reliable biomarkers for progression to neoplasia in BE; and the role of bone marrow stem cells in the morphogenesis of Barrett's esophagus. Author Affiliation: (1)Rodger C. Haggitt Gastrointestinal and Hepatic Pathology Service, University of Washington, Seattle, Washington. (2)Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio. (3)Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany. (4)Medical Clinic I, University of Erlangen, Erlangen, Germany. (5)Institute of Pathology, Medical University Graz, Graz, Austria
    Keywords: Cancer Research ; Tumor Proteins ; Multiple Myeloma ; Dysplasia ; Stem Cells ; Stem Cell Research ; Barrett Esophagus
    ISSN: 0077-8923
    Source: Cengage Learning, Inc.
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  • 6
    Language: English
    In: Diagnostic Histopathology, July 2015, Vol.21(7), pp.290-298
    Description: Inflammation plays a major role in the development of carcinomas in IBD. The previous role of stromal cells has probably been underestimated in the past. In general treatment regimens aim to reduce the inflammation to prevent carcinoma. Endoscopy and histopathology play a major role not only in diagnosis of neoplasia but also in removal and staging and have to follow strict steps to ensure high quality. At our institution about 90% of all carcinomas in IBD are cases of ulcerative colitis. Therefore, we focus on the present manuscript more on ulcerative colitis rather than carcinoma in Crohn's disease. Sometimes outside from specialized centres partial colectomies are carried out in cases with carcinomas in ulcerative colitis instead of performing complete proctocolectomies. Our retrospective data show that there is a higher risk for relapses from lymph node metastasis but also for metachronous lesions. The survival rates are almost comparable but complete colectomies are still the treatment of choice for carcinomas in ulcerative colitis.
    Keywords: Carcinoma ; Crohn'S Disease ; Histology ; Treatment ; Ulcerative Colitis ; Medicine
    ISSN: 1756-2317
    E-ISSN: 1876-7621
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  • 7
    Language: English
    In: Cancer, 01 February 2012, Vol.118(3), pp.628-638
    Description: BACKGROUND: Blood vessel invasion has been associated with poor outcome in colorectal cancer (CRC), whereas the prognostic impact of lymphatic invasion is less clear. The authors of this report evaluated venous and lymphatic invasion as potential prognostic indicators in patients with CRC focusing on lymph node-negative patients and compared routine and review pathology diagnoses.METHODS: In total, 381 tumors from randomly selected patients were retrospectively reviewed. The presence of vascular invasion was related to disease-free and cancer-specific survival using the Kaplan-Meier method. For multivariable analysis, Cox proportional hazards regression models were performed.RESULTS: Lymphatic invasion and venous invasion were observed in 126 patients (33%) and 87 patients (23%), respectively, and were associated significantly with tumor classification, lymph node status, American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) disease stage, tumor differentiation, pattern of invasion, and extent of tumor budding. The detection of vascular invasion was related to the number of examined tissue blocks. Venous and lymphatic invasion proved to be significant prognostic variables in univariable and multivariable analyses. Extramural vascular involvement was of particular significance. When the analysis was restricted to patients with (AJCC/UICC) stage II disease, venous invasion, but not lymphatic invasion, was identified as an independent prognostic variable. Review pathology diagnoses differed significantly from routine diagnoses with respect to prognostic impact.CONCLUSIONS: Venous and lymphatic invasion proved to be significant prognostic variables in patients with CRC. The detection of vascular invasion and, consequently, risk stratification of affected patients were related to the quality of pathology workup, ie, the number of examined tissue blocks. Observed differences between review and routine pathology diagnoses illustrated the need for high-quality pathology reporting and also for standardized quality control.
    Keywords: Colorectal Cancer ; Lymphatic Invasion ; Venous Invasion ; Vascular Invasion ; Routine Pathology ; Review Pathology ; Outcome ; Prognosis ; Quality Control
    ISSN: 0008-543X
    E-ISSN: 1097-0142
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  • 8
    Language: English
    In: Virchows Archiv, 2011, Vol.458(1), pp.21-30
    Description: Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document includes a chapter on pathology with pan-European recommendations which take into account the diversity and heterogeneity of health care systems across the EU. The present paper is based on the annex to the pathology chapter which attempts to describe in greater depth some of the issues raised in the chapter in greater depth, particularly details of special interest to pathologists. It is presented here to make the relevant discussion known to a wider scientific audience.
    Keywords: Colorectal cancer screening ; Multidisciplinary evidence-based guidelines ; Quality assurance ; Histopathology ; Classification ; Precursor lesions
    ISSN: 0945-6317
    E-ISSN: 1432-2307
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  • 9
    In: Annals of the New York Academy of Sciences, October 2013, Vol.13001(1), pp.200-212
    Description: This paper presents commentaries on reflux‐induced injury of human esophageal epithelium; inflammation in human reflux esophagitis; motor consequences of reflux‐induced inflammation in esophageal epithelium; the microscopic morphology of esophageal squamous epithelium; intraluminal impedance in the evaluation of the esophageal mucosa; endoscopic tissue morphology of esophageal squamous epithelium; and the developmental biology of esophageal squamous epithelium.
    Keywords: Gerd ; Esophageal Squamous Epithelium ; Erosive Esophagitis ; Eosinophilic Esophagitis
    ISSN: 0077-8923
    E-ISSN: 1749-6632
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  • 10
    Language: English
    In: Gastroenterology, November 2016, Vol.151(5), pp.822-835
    Description: The purpose of this clinical practice update expert review is to define the key principles in the diagnosis and management of low-grade dysplasia (LGD) in Barrett’s esophagus patients. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). The extent of Barrett’s esophagus should be defined using a standardized grading system documenting the circumferential and maximal extent of the columnar lined esophagus (Prague classification) with a clear description of landmarks and visible lesions (nodularity, ulceration) when present. : Given the significant interobserver variability among pathologists, the diagnosis of Barrett’s esophagus with LGD should be confirmed by an expert gastrointestinal pathologist (defined as a pathologist with a special interest in Barrett’s esophagus–related neoplasia who is recognized as an expert in this field by his/her peers). Expert pathologists should report audits of their diagnosed cases of LGD, such as the frequency of LGD diagnosed among surveillance patients and/or the difference in incidence of neoplastic progression among patients diagnosed with LGD vs nondysplastic Barrett’s esophagus. Patients in whom the diagnosis of LGD is downgraded to nondysplastic Barrett’s esophagus should be managed as nondysplastic Barrett’s esophagus. In Barrett’s esophagus patients with confirmed LGD (based on expert gastrointestinal pathology review), repeat upper endoscopy using high-definition/high-resolution white-light endoscopy should be performed under maximal acid suppression (twice daily dosing of proton pump inhibitor therapy) in 8–12 weeks. Under ideal circumstances, surveillance biopsies should not be performed in the presence of active inflammation (erosive esophagitis, Los Angeles grade C and D). Pathologists should be informed if biopsies are obtained in the setting of erosive esophagitis and if pathology findings suggest LGD, or if no biopsies are obtained, surveillance biopsies should be repeated after the anti-reflux regimen has been further intensified. Surveillance biopsies should be performed in a four-quadrant fashion every 1–2 cm with target biopsies obtained from visible lesions taken first. Patients with a confirmed histologic diagnosis of LGD should be referred to an endoscopist with expertise in managing Barrett’s esophagus–related neoplasia practicing at centers equipped with high-definition endoscopy and capable of performing endoscopic resection and ablation. Endoscopic resection should be performed in Barrett’s esophagus patients with LGD with endoscopically visible abnormalities (no matter how subtle) in order to accurately assess the grade of dysplasia. In patients with confirmed Barrett’s esophagus with LGD by expert GI pathology review that persists on a second endoscopy, despite intensification of acid-suppressive therapy, risks and benefits of management options of endoscopic eradication therapy (specifically adverse events associated with endoscopic resection and ablation), and ongoing surveillance should be discussed and documented. Endoscopic eradication therapy should be considered in patients with confirmed and persistent LGD with the goal of achieving complete eradication of intestinal metaplasia. Patients with LGD undergoing surveillance rather than endoscopic eradication therapy should undergo surveillance every 6 months times 2, then annually unless there is reversion to nondysplastic Barrett’s esophagus. Biopsies should be obtained in 4-quadrants every 1–2 cm and of any visible lesions. In patients with Barrett’s esophagus–related LGD undergoing ablative therapy, radiofrequency ablation should be used. Patients completing endoscopic eradication therapy should be enrolled in an endoscopic surveillance program. Patients who have achieved complete eradication of intestinal metaplasia should undergo surveillance every year for 2 years and then every 3 years thereafter to detect recurrent intestinal metaplasia and dysplasia. Patients who have not achieved complete eradication of intestinal metaplasia should undergo surveillance every 6 months for 1 year after the last endoscopy, then annually for 2 years, then every 3 years thereafter. Following endoscopic eradication therapy, the biopsy protocol of obtaining biopsies in 4 quadrants every 2 cm throughout the length of the original Barrett’s esophagus segment and any visible columnar mucosa is suggested. Endoscopists performing endoscopic eradication therapy should report audits of their rates of complete eradication of dysplasia and intestinal metaplasia and adverse events in clinical practice.
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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