Barrett's Esophagus With Dysplasia
Conditions
Brief summary
To prospectively assess the functional aspects of the the esophageal squamous epithelial barrier and correlate this with tissue inflammation and intercellular space dilation in patients who have successfully completed endoscopic radiofrequency ablation versus balloon cryotherapy for Barrett's Esophagus related metaplasia.
Detailed description
The investigators will measure and correlate mucosal impedance (measured using a novel endoscopic mucosal impedance catheter), intercellular space as measured with transmission electron microscopy and tissue levels of prostaglandin E2 in patients undergoing surveillance following successful endoscopic therapy (defined as two negative endoscopic surveillance histology for intestinal metaplasia). Mucosal impedance will be measured by an endoscopic probe. Research biopsies will also be obtained for measurement of tissue levels of prostaglandin E2 and intracellular space with transmission electron microscopy. Volumetric laser endomicroscopy will measure the precise thickness of and area of subsquamous structures underneath the neosquamous epithelium.
Interventions
DEVICEMucosal Impedance
Aim 1: Mucosal impedance will be measured by an endoscopic probe 1 cm above the gastroesophageal junction, 5 cm above the gastroesophageal junction and in the proximal esophagus in an area not exposed to the index therapeutic radiofrequency ablation. Aim 2: Mucosal impedance will be measured 1 cm above gastroesophageal junction, 1 cm below previous squamous columnar junction, 1 cm above previous squamocolumnar junction.
OTHERResearch Biopsies
Aim 1: Research biopsies will be obtained at 1 cm above the gastroesophageal junction, 5 cm above the gastroesophageal junction, and in the proximal esophagus in an area not exposed to the index therapeutic radiofrequency ablation. Aim 2: Aim 2: Research biopsies will be taken 1 cm above gastroesophageal junction, 1 cm below previous squamous columnar junction, 1 cm above previous squamocolumnar junction.
DEVICEVolumetric Laser Endomicroscopy
Aim 2: Volumetric laser endomicroscopy will be done and marked at 1 cm above gastroesophageal junction, 1 cm below previous squamous columnar junction, 1 cm above previous squamocolumnar junction.
Sponsors
Mayo Clinic
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Adults (age 18-90) who underwent an ablative program for BE
Exclusion criteria
* Patients that have not achieved complete remission of intestinal metaplasia. * Patients unable to consent. * Pregnant women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mucosal Impedance as measured by an endoscopic probe | Up to two years | Assess the mucosal impedance of neosquamous epithelium after successful treatment of Barrett's Esophagus. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tissue levels of prostaglandin E2 | Up to two years | Assess the levels of prostaglandin E2 in neosquamous epithelium after successful treatment of Barrett's Esophagus. |
| Intracellular space | Up to two years | Assess the intercellular space in neosquamous epithelium following successful treatment of Barrett's Esophagus with use of transmission electron microscopy. |
| Volumetric Laser Endomicroscopy | Up to two years | Assess and measure precise thickness of and area of subsquamous structions underneath the neosquamous epithelium. |
Countries
United States
Outcome results
None listed