Sponge cytology combined with endoscopy in patients with long-segment Barrett's esophagus: A retrospective case series and literature review.

Abstract

This study summarized the clinical characteristics and endoscopic findings in patients with long-segment Barrett's esophagus through a retrospective analysis of the clinical data of three patients with long-segment Barrett's esophagus. Data from patients, including demographic characteristics, medical history, endoscopy findings, pathological diagnosis, and esophageal sponge cytology results were analyzed, and a literature review was performed. Three patients were included; all were male with a mean age of 67.3 ± 7.1 years. Symptoms encompassed heartburn (3/3), acid reflux (2/3), belching (1/3), retrosternal pain (1/3), abdominal distension (1/3), and dysphagia (1/3). Risk factors included alcohol use (3/3), consumption of pickled and hot foods or beverages (3/3), smoking (1/3), and familial esophageal disease history (1/3). Endoscopically, Prague C & M criteria measurements were C₁₃M₁₅, C₄M₁₀, and C₆M₇, with long-segment Barrett's esophagus lesions spanning the upper/middle/lower esophagus; all showed circumferential involvement and coexisted with gastroesophageal reflux disease. Concurrently, two patients presented with all the following three conditions: hiatal hernia, chronic atrophic gastritis, and Helicobacter pylori infection. Pathologically, one patient showed early intramucosal adenocarcinoma, whereas two had intestinal metaplasia. Sponge cytology identified grade 3 atypical cells in one patient and grade 2 hyperplasia in two patients. In conclusion, long-segment Barrett's esophagus is strongly associated with gastroesophageal reflux disease and necessitates endoscopic surveillance, whereas sponge cytology screening has shown initial feasibility but requires standardized protocols and multicenter validation for clinical integration.