Brush cytology in the diagnosis of neoplasia in Barrett’s esophagus

Hardwick, Richard; Morgan, Richard; Warren, Bryan F.; Lott, M.; Alderson, Derek

doi:10.1093/dote/10.4.233

Cited by 26 publications

(14 citation statements)

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“…However, its sensitivity for the detection of low-grade dysplasia is limited, which constitutes one of the reasons why cytology is currently only rarely performed as part of routine surveillance in the United States. 29,30 Ancillary …”

Section: Discussionmentioning

confidence: 99%

Chromosomal gains and genomic loss of p53 and p16 genes in Barrett's esophagus detected by fluorescence in situ hybridization of cytology specimens

et al. 2004

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Endoscopic brush cytology is a promising surveillance technique for Barrett's esophagus. Ancillary markers are sought to increase the sensitivity of cytology and allow identification of patients at increased risk for disease progression. To determine if there are specific genetic changes in Barrett's esophagus with associated high-grade dysplasia/intramucosal adenocarcinoma compared to those without dysplasia, we performed fluorescence in situ hybridization (FISH) on cytologic specimens using probes to chromosomes and genomic regions previously described as altered in this disease. We studied archival brush cytology slides from 40 Barrett's esophagus patients: 21 with biopsy-proven high-grade dysplasia/carcinoma and 19 with no dysplasia and a minimum 5 years of negative follow-up. Centromeric enumeration probes (CEP) for chromosomes 6, 7, 11, and 12, and locus-specific probes (LSI) for 9p21 (p16 gene), and 17p13.1 (p53 gene) loci along with their corresponding CEP (9 and 17, respectively) were used in this study. A positive FISH result was defined as the presence of cells with 42 CEP signals or with a loss of the LSI signals relative to their corresponding CEP. p53 locus loss and/or aneusomy of chromosomes 6, 7, 11, and 12 abnormalities could be detected by FISH in routinely processed endoscopic brush cytology specimens from 95% of biopsy-positive cases with a specificity of 100%. Interestingly, all five cases with cytologic changes classified as indefinite for dysplasia from patients with a positive biopsy showed changes by FISH. Loss of the p16 locus was seen commonly in patients both with and without dysplasia/carcinoma. Selected biomarkers from this study merit further investigation to determine their potential to detect genetic changes in patients with Barrett's esophagus prior to the development of high-grade dysplasia.

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Section: Discussionmentioning

confidence: 99%

Chromosomal gains and genomic loss of p53 and p16 genes in Barrett's esophagus detected by fluorescence in situ hybridization of cytology specimens

et al. 2004

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“…Brush cytology has been used as an adjunct to conventional biopsy and histopathology (115). Currently, few pathologists would advocate the use of cytology in this clinical context.…”

Section: Tissue Biomarkersmentioning

confidence: 99%

Biomarkers of Esophageal Adenocarcinoma and Barrett’s Esophagus

2004

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The rising incidence and poor prognosis of esophageal adenocarcinoma in the Western world have intensified research efforts into earlier methods of detection of this disease and its relationship to Barrett's esophagus. The progression of Barrett's esophagus to adenocarcinoma has been the focus of particular scrutiny, and a number of potential tissue and serum-based disease biomarkers have emerged. The epidemiology and pathogenesis of esophageal adenocarcinoma are outlined. Tissue biomarkers allowing risk stratification of Barrett's are reviewed as well as strategies currently being used to discover novel biomarkers that will facilitate the early detection of esophageal adenocarcinoma. Finally, the uses of biomarkers as predictive tests for targeted treatments and as surrogate endpoints in chemoprevention trials are considered.

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“…1 Further, cytology and histology can be complementary to each other in the evaluation of patients with BE. [3][4][5] However certain difficult situations have been highlighted by some authors. 6 In the present study, we report eight cases of BE with or without associated adenocarcinoma, diagnosed either on cytology alone or histology alone, or with a combination of both the techniques.…”

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confidence: 99%

Role of brush cytology in the diagnosis of Barrett's esophagus: An analysis of eight cases

Padmavathy

Siddaraju

Sistla

2010

Diagnostic Cytopathology

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Although debatable, role of cytology in diagnosing Barrett's esophagus has been stressed by some authors. Our brief report analyses the role of brush cytology (BC) in its diagnosis. Eight patients who presented with upper gastrointestinal (GI) manifestations and subsequently diagnosed to have Barrett's esophagus with or without adenocarcinoma on brush cytology (BC) or, endoscopic biopsy (EB) or, a combination of both the techniques were included in the study. In all the cases routine cytologic smears and histologic sections with relevant special stains (when essential) were studied. On cytology, the diagnosis of "Barrett's esophagus" was made when the esophageal brushings obtained from a region beyond 3 cm from the gastroesophageal junction showed closely intermingled clusters of squamous and columnar cells, or when there was evidence of intestinal metaplasia. Adenocarcinoma in Barrett's esophagus was diagnosed by the usual criteria for malignancy with features of adenocarcinoma. Cytologic diagnoses were correlated with the histologic diagnoses. Of the eight cases, seven had histopathologic correlation of which six had evidence of BE on BC; four had cytohistologic concordance, of which three cases revealed adenocarcinoma arising in BE. Two endoscopic biopsies were nonrepresentative. In one case, cytology missed Barrett's esophagus. For two cases in which cytology detected Barrett's mucosa, biopsies were nonrepresentative. Our study showed brush cytology (BC) to be a fairly reliable test for detecting Barrett's esophagus. Owing to its inherent advantage of sampling a wider and circumferential area, a technically well performed brushing procedure is likely to be more representative and superior than multiple endoscopic biopsies.

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Brush cytology in the diagnosis of neoplasia in Barrett’s esophagus

Cited by 26 publications

References 0 publications

Chromosomal gains and genomic loss of p53 and p16 genes in Barrett's esophagus detected by fluorescence in situ hybridization of cytology specimens

Chromosomal gains and genomic loss of p53 and p16 genes in Barrett's esophagus detected by fluorescence in situ hybridization of cytology specimens

Biomarkers of Esophageal Adenocarcinoma and Barrett’s Esophagus

Role of brush cytology in the diagnosis of Barrett's esophagus: An analysis of eight cases

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