Barrett's mucosa, Barrett's dysplasia and Barrett's carcinoma: diagnostic endoscopy without biopsy-taking does not suffice

Many gastroenterologists are of the opinion that endoscopic diagnosis of ga stro-oesophageal reflux disease (GORD) suffices and that additional biopsie s are not necessary. The data obtained from 1068 consecutive patients with histologically confirmed Barrett's oesophagus were analysed retrospectively . In 37.9% of the patients, the histological diagnosis of Barrett's oesopha gus was an incidental finding, whereas 32.7% of Barrett's carcinomas were d iagnosed only at histology but not during endoscopy. Of the Patients with d ysplasia, 92.4% were diagnosed only by the pathologist. Our analysis shows that an endoscopic diagnosis suspicious for Barrett's mucosa is made in 62. 1% of the cases, carcinoma in 70%, and dysplasia in only 7.6% of the cases. Also, because neoplasia is detected for the most part at the invasive carc inoma state, but not in the dysplasia stage, the diagnosis of Barrett's oes ophagus, with and without dysplasia, needs to be improved by additional bio psies for histopathological investigation.