MORPHOLOGICAL DIAGNOSTIC OF BARRETT’S ESOPHAGUS IN SCREENING ENDOSCOPY EXAMINATION

Barrett's esophagus (BE) is characterized by the replacement of the normal stratified squamous epithelium lining of the esophagus by simple columnar epithelium. The medical significance of Barrett's esophagus is its strong association with progression from intestinal metaplasia to low-grade dysplasia, high-grade dysplasia and finally to esophageal adenocarcinoma. The main method of diagnostic of BE is an endoscopy, but the diagnosis of BE must be confirmed by morphological examination. The Aim is to analyze the frequency of detection of BE according to the results of morphological study with the definition of the type of metaplastic and the degree of dysplastic changes in screening esophagogastroscopy. Materials and methods. A retrospective analysis of cases of diagnosis of BE for the years 2011-2016 with the definition of different types of metaplasia and degrees of dysplasia was conducted. 95% confidence interval is presented. Results. BE was diagnosed in 241 (4.2%) cases of 5686 (100%) esophagogastroscopies; the odds ratio is 95% (241/5696), the confidence interval is 3.7-4.7%. Five subtypes of endoscopic features of the esophagus mucosa in BE were found: 1) circular fosses, regular fosses; 2) oval fosses, regular microvascularisation; 3) villous/ wrinkled fosses, regular microvascularisation; 4) absence of fosses, regular microvascularisation; 5) destroyed fosses, irregular microvascularisation. 1st st type corresponds fundus type of epithelium histologically, 2nd nd – cardiac type, 3rd - special-ized intestinal metaplasia, 4th and 5th types correspond to the types of epithelial dysplasia of epithelium of distal part of esophagus. Histologically cardiac metaplasia was detected in 84 (34.9%) of 241 patients, fundal metaplasia in 50 (20.7%) cases; specialized intestinal metaplasia in 107 (44.4%) patients. The diagnosis of dysplasia was established in 44 (18.3%) cases (odds ratio 95% (44/241), confidence interval 13.4-23.2%). In 12 (27%) cases of 44 (100%) dysplasia was high grade, in 32 (73%) cases it was low grade. There were no cases of adenocarcinoma from BE. Conclusions. Morphological conclusion is the main objective criterion for the verification of the BE, which is important in choosing treatment tactics and a certain value in determining the prognosis of the disease. BE was diagnosed in 4.7% of the screening endoscopy, which coincides with the frequency of detection of PB in the population (2-7%). A high percentage of dysplasia of the epithelium PB (18.3%) is determined, which confirms the potential risk of malignancy.