Predictors of Progression in Barrett's Esophagus: Current Knowledge and Future Directions

Overview

Journal Am J Gastroenterol

Specialty Gastroenterology

Date 2010 Jan 28

PMID 20104216

Citations 40

Authors

Ganapathy A Prasad

Ajay Bansal

Prateek Sharma

Kenneth K Wang

Affiliations

Soon will be listed here.

Abstract

Barrett's esophagus (BE) is the strongest risk factor for esophageal adenocarcinoma (EAC), a malignancy with persistently poor long-term outcomes. EAC is thought to develop through progression of metaplasia to dysplasia to invasive carcinoma. Identification of factors predicting progression to EAC would help in focusing surveillance, chemoprevention, or ablation for those deemed to be at highest risk of progression. We performed a comprehensive review of the literature and summarized current evidence on risk factors for progression in subjects with known BE. Clinical and demographic factors (age, male gender, length of BE segment) are associated with modestly increased odds of progression to EAC in some studies. Biomarkers such as aneuploidy and p53 loss of heterozygosity have been associated with increased risk of progression to high-grade dysplasia and/or EAC in single-center prospective cohort studies. Promising newer techniques and markers have been recently reported with the potential to help risk stratify BE subjects. Development of a comprehensive BE risk progression score comprised of both clinical and biomarker variables should be the ultimate goal and can be achieved by multicenter prospective collaborative efforts. Although it would be challenging, creation of such a score has the potential to improve outcomes and make the management of patients with BE more cost-effective.

Citing Articles

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References

Barritt 4th A, Shaheen N . Should patients with Barrett's oesophagus be kept under surveillance? The case against. Best Pract Res Clin Gastroenterol. 2008; 22(4):741-50. DOI: 10.1016/j.bpg.2007.12.005. View

Montgomery E, Goldblum J, Greenson J, Haber M, Lamps L, Lauwers G . Dysplasia as a predictive marker for invasive carcinoma in Barrett esophagus: a follow-up study based on 138 cases from a diagnostic variability study. Hum Pathol. 2001; 32(4):379-88. DOI: 10.1053/hupa.2001.23511. View

Going J, Keith W, Neilson L, Stoeber K, Stuart R, Williams G . Aberrant expression of minichromosome maintenance proteins 2 and 5, and Ki-67 in dysplastic squamous oesophageal epithelium and Barrett's mucosa. Gut. 2002; 50(3):373-7. PMC: 1773132. DOI: 10.1136/gut.50.3.373. View

Riddell R, Goldman H, Ransohoff D, Appelman H, Fenoglio C, Haggitt R . Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Hum Pathol. 1983; 14(11):931-68. DOI: 10.1016/s0046-8177(83)80175-0. View

Yousef F, Cardwell C, Cantwell M, Galway K, Johnston B, Murray L . The incidence of esophageal cancer and high-grade dysplasia in Barrett's esophagus: a systematic review and meta-analysis. Am J Epidemiol. 2008; 168(3):237-49. DOI: 10.1093/aje/kwn121. View

Galipeau P, Li X, Blount P, Maley C, Sanchez C, Odze R . NSAIDs modulate CDKN2A, TP53, and DNA content risk for progression to esophageal adenocarcinoma. PLoS Med. 2007; 4(2):e67. PMC: 1808095. DOI: 10.1371/journal.pmed.0040067. View

Dong L, Kristal A, Peters U, Schenk J, Sanchez C, Rabinovitch P . Dietary supplement use and risk of neoplastic progression in esophageal adenocarcinoma: a prospective study. Nutr Cancer. 2008; 60(1):39-48. PMC: 2366201. DOI: 10.1080/01635580701586762. View

Halling K, Kipp B . Fluorescence in situ hybridization in diagnostic cytology. Hum Pathol. 2007; 38(8):1137-44. DOI: 10.1016/j.humpath.2007.04.015. View

Christophorou M, Ringshausen I, Finch A, Swigart L, Evan G . The pathological response to DNA damage does not contribute to p53-mediated tumour suppression. Nature. 2006; 443(7108):214-7. DOI: 10.1038/nature05077. View

10.

Bani-Hani K, Bani-Hani B, Martin I . Characteristics of patients with columnar-lined Barrett's esophagus and risk factors for progression to esophageal adenocarcinoma. World J Gastroenterol. 2006; 11(43):6807-14. PMC: 4725040. DOI: 10.3748/wjg.v11.i43.6807. View

11.

Inadomi J, Sampliner R, Lagergren J, Lieberman D, Fendrick A, Vakil N . Screening and surveillance for Barrett esophagus in high-risk groups: a cost-utility analysis. Ann Intern Med. 2003; 138(3):176-86. DOI: 10.7326/0003-4819-138-3-200302040-00009. View

12.

Hillman L, Chiragakis L, Shadbolt B, Kaye G, Clarke A . Proton-pump inhibitor therapy and the development of dysplasia in patients with Barrett's oesophagus. Med J Aust. 2004; 180(8):387-91. DOI: 10.5694/j.1326-5377.2004.tb05991.x. View

13.

Vakil N, van Zanten S, Kahrilas P, Dent J, Jones R . The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006; 101(8):1900-20. DOI: 10.1111/j.1572-0241.2006.00630.x. View

14.

Maley C, Galipeau P, Li X, Sanchez C, Paulson T, Blount P . The combination of genetic instability and clonal expansion predicts progression to esophageal adenocarcinoma. Cancer Res. 2004; 64(20):7629-33. DOI: 10.1158/0008-5472.CAN-04-1738. View

15.

Attwood S, Barlow A, Norris T, Watson A . Barrett's oesophagus: effect of antireflux surgery on symptom control and development of complications. Br J Surg. 1992; 79(10):1050-3. DOI: 10.1002/bjs.1800791021. View

16.

Fitzgerald R, Omary M, Triadafilopoulos G . Dynamic effects of acid on Barrett's esophagus. An ex vivo proliferation and differentiation model. J Clin Invest. 1996; 98(9):2120-8. PMC: 507657. DOI: 10.1172/JCI119018. View

17.

Brankley S, Wang K, Harwood A, Miller D, Legator M, Lutzke L . The development of a fluorescence in situ hybridization assay for the detection of dysplasia and adenocarcinoma in Barrett's esophagus. J Mol Diagn. 2006; 8(2):260-7. PMC: 1867582. DOI: 10.2353/jmoldx.2006.050118. View

18.

Corley D, Levin T, Habel L, Weiss N, Buffler P . Surveillance and survival in Barrett's adenocarcinomas: a population-based study. Gastroenterology. 2002; 122(3):633-40. DOI: 10.1053/gast.2002.31879. View

19.

Weston A, Sharma P, Mathur S, Banerjee S, Jafri A, Cherian R . Risk stratification of Barrett's esophagus: updated prospective multivariate analysis. Am J Gastroenterol. 2004; 99(9):1657-66. DOI: 10.1111/j.1572-0241.2004.30426.x. View

20.

Schulmann K, Sterian A, Berki A, Yin J, Sato F, Xu Y . Inactivation of p16, RUNX3, and HPP1 occurs early in Barrett's-associated neoplastic progression and predicts progression risk. Oncogene. 2005; 24(25):4138-48. DOI: 10.1038/sj.onc.1208598. View