Early Diagnostic Biomarkers for Esophageal Adenocarcinoma—The Current State of Play

Abstract

Esophageal adenocarcinoma (EAC) is one of the two most common types of esophageal cancer with alarming increase in incidence and very poor prognosis. Aiming to detect EAC early, currently high-risk patients are monitored using an endoscopic-biopsy approach. However, this approach is prone to sampling error and interobserver variability. Diagnostic tissue biomarkers related to genomic and cell-cycle abnormalities have shown promising results, although with current technology these tests are difficult to implement in the screening of high-risk patients for early neoplastic changes. Differential miRNA profiles and aberrant protein glycosylation in tissue samples have been reported to improve performance of existing tissue-based diagnostic biomarkers. In contrast to tissue biomarkers, circulating biomarkers are more amenable to population-screening strategies, due to the ease and low cost of testing. Studies have already shown altered circulating glycans and DNA methylation in BE/EAC, whereas disease-associated changes in circulating miRNA remain to be determined. Future research should focus on identification and validation of these circulating biomarkers in large-scale trials to develop in vitro diagnostic tools to screen population at risk for EAC development. Cancer Epidemiol Biomarkers Prev; 22(7); 1185-209. Ó2013 AACR.

Evaluation of Serum Glycoprotein Biomarker Candidates for Detection of Esophageal Adenocarcinoma and Surveillance of Barrett's Esophagus

“…Over the years, several studies have been carried out to identify circulatory biomarker candidates to diagnose BE-dysplasia-EAC disease spectrum (19,28). These studies have explored genetic alterations in cell free circulating DNA (29) …”

“…A less costly and minimally invasive diagnostic procedure is needed for cost-effective screening and surveillance of at-risk populations (18,19).…”

LC–MS/MS Quantitation of Esophagus Disease Blood Serum Glycoproteins by Enrichment with Hydrazide Chemistry and Lectin Affinity Chromatography

“…30 Like other cancers, the survival rate of EAC patients increases if patients are diagnosed in early stages of the disease. 34 Hence, there is a pressing need to determine diagnostic biomarkers capable of detecting the disease in an early stage. Like other cancers, EAC is believed to develop in a stepwise manner, and it is thought that its precursor lesion is high-grade dysplasia (HGD) of metaplastic esophageal epithelium.…”

Annual computed tomography scans do not improve outcomes following esophagectomy for cancer: a 10-year UK experience

“…The best strategy probably involves customized programs based on the treatment offered for recurrence and other network‐specific resources, as well as the views of the informed patient . Perhaps novel biomarker discovery may yield cheaper, more sensitive, and acceptable screening tools to help mitigate this problem . For the time being, further studies are required to answer the question fully, considering oncological end‐points as well as quality of life and cost implications.…”