Progression from low-grade dysplasia to malignancy in patients with Barrett's esophagus diagnosed by two or more pathologists

Table 1 Basic characteristics of the included studies

Ref.	Country	Type	Age: years - Median	Sex: Male%	N LGD - prior to panel review	Follow up - median - months	Follow up - Patient years	N LGD (after panel review) consensus diagnosis	N HGD (after panel review) consensus diagnosis
Picardo et al[27] 2015	Ireland	R	59	67%	NA	50	354.17	85	60
Duits et al[28] 2014	Netherlands	R	63	76%	293	39	256.75	79	NA
von Rahden et al[29] 2008	Germany	R	59	72%	NA	24	114.00	57	NA
Lim et al[30] 2007	United Kingdom	R	67	80%	34	96	112.00	14	1
Vieth et al[31] 2006	Germany	R	61	68%	NA	54	85.50	19	10
Basu et al[32] 2004	United Kingdom	R	74	74%	16	60	50.00	10	3
Montgomery et al[33] 2001	United States	R	65	72%	26	24	30.00	15	15
Skacel et al[34] 2000	United States	R	67	84%	25	26	36.83	17	NA
Younes et al[35] 2011	United States	P	NA	NA	NA	35	81.67	28	NA
Wani et al[10] 2011	United States	P	61	85%	210	74	252.83	41	NA
Curvers et al[36] 2010	Netherlands	P	59	67%	147	51	93.50	22	NA
Srivastava et al[37] 2007	United States	P	64	91%	NA	25	64.58	31	46

R: Retrospective; P: Prospective; NA: Not available.

Table 2 Key characteristics of individual studies

Study	Patient registry	Diagnosis method of LGD	Biopsy details
Picardo et al[27] 2015	Specialist center based registry	Expert pathologist panel: 2 pathologists required to make diagnosis	Four-quadrant biopsies every 1 cm of Barrett's esophagus
Duits et al[28] 2014	Specialist center based registry	Expert pathologists panel: At-least 2 pathologists required to make diagnosis	H&E stained slides of paraffin embedded biopsy specimens
von Rahden et al[29] 2008	Specialist center and Community population based registry	Expert pathologists panel: 3 pathologists required to make diagnosis	Multiple biopsies at different levels of Barrett’s esophagus
Lim et al[30] 2007	Specialist center based registry	Expert pathologists panel: 5 pathologists required to make diagnosis	Four to ten (sometimes more) biopsies taken from Barrett's area. Hematoxylin and eosin staining
Vieth et al[31] 2006	Specialist center based registry	Biopsies assessed twice by two pathologists in a blinded fashion	Four biopsies every 2 cm in relation to the Barrett’s esophagus length
Basu et al[32] 2004	Community based cohort	Experienced gastrointestinal pathologist assessed histological sections, with confirmation by a colleague if high-grade dysplasia or worse was suspected. All cases of low-grade dysplasia were reviewed at a regular gastrointestinal histopathology meeting	2-cm interval quadrantic biopsies in the entire length of Barrett’s esophagus
Montgomery et al[33] 2001	Specialist center based registry	Expert pathologists panel: 12 pathologists required to make diagnosis - reviewed blindly twice by each pathologist	Multiple biopsies at different levels of Barrett’s esophagus. Submitted biopsy specimen had to show the worst lesion that the patient was known to have at the time of the initial known endoscopy
Skacel et al[34] 2000	Specialist center based registry	Expert pathologists panel: LGD cases were randomized and blindly reviewed by three gastrointestinal pathologists	Four-quadrant biopsies taken using jumbo forceps at intervals of < 2 cm throughout the length of the Barrett’s segment, with additional biopsies of any endoscopic lesions. All biopsy specimens had been fixed in formalin or Hollande’s solution
Younes et al[45] 2011	Specialist center based registry	Expert pathologist panel: 2 pathologists required to make diagnosis	Biopsies from two or more levels in barrett's esophagus. Hematoxylin-eosin–stained sections of formalin-fixed and paraffin-embedded tissue
Wani et al[10] 2011	Specialist center based registry	Consensus diagnosis among two or more pathologists: defined as agreement between the local GI pathologist and expert central pathologists	At least 4 quadrant biopsies every 2 cm with either a standard or jumbo biopsy forceps. Hematoxylin Eosin stained slides of paraffin-embedded biopsy specimens
Curvers et al[36] 2010	Community based cohort	Expert pathologist panel: 2 pathologists required to make diagnosis	All visible abnormalities were sampled, followed by random sampling of the Barrett segment in four quadrants every 2 cm. Hematoxylin and eosin stained slides of paraffin-embedded biopsy specimens
Srivastava et al[37] 2007	Specialist center based registry	Expert pathologists panel: 3 pathologists required to make diagnosis	Four-quadrant endoscopic esophageal mucosal biopsies were obtained at every 1–2 cm. All four-quadrant Hollande’s or formalin fixed biopsies were embedded into one paraffin block and serial 4 µm thick tissue sections were cut and stained with hematoxylin and eosin