Meta-analysis of biomarkers predicting risk of malignant progression in Barrett's oesophagus

Altaf, Kiran; Xiong, Junjie; Iglesia, Daniel de la; Hickey, L.; Kaul, Anil

doi:10.1002/bjs.10484

Cited by 28 publications

(18 citation statements)

References 46 publications

(48 reference statements)

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“…18 From a meta-analysis of biomarkers predicting risk of malignant progression in Barrett esophagus, by Altaff et al, markers of genomic instability, as loss and mutation of p53, overexpression of Ki-67 and presence of aneuploidy, were reasonably efficient in predicting a higher risk of progressing to HGD and cancer. 19 Recently, Dong et al 20 developed a model to determine risk of Barrett's esophagus or esophageal adenocarcinoma, based on genetic and non-genetic factors even still is not clear if it will justify its clinical use. 20 New evidences are added day-by-day to support the role of smoking cigarettes and the mean length of BE, like known risk factors in the progression of the HGD to cancer but in the present study, these variables were not aims of study.…”

Section: Discussionmentioning

confidence: 99%

Clinical picture of patients with Barrett’s esophagus and different grades of dysplasia

Escobar¹,

Velázquez²

2018

GHOA

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Introduction: Barrett's esophagus (BE) is the most relevant premalignant condition for the development of carcinoma of the esophagus, and the presence of dysplasia represents a progression marker. Objectives: To identify the different clinical manifestations in a group of patients with BE and different grades of dysplasia. Methods: An observational, descriptive and transversal study was carried out which included 86 patients with a diagnosis of BE seen at the Endoscopy Department from the National Center for Minimally Invasive Surgery between January 2012 and January 2014. Clinical-epidemiological variables were compared according to the presence or not of dysplasia and its grade.

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Section: Discussionmentioning

confidence: 99%

Clinical picture of patients with Barrett’s esophagus and different grades of dysplasia

Escobar¹,

Velázquez²

2018

GHOA

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“…Our meta-analysis is the first to show that BE patients, independent of the presence of LGD, with aberrant p53 IHC have a similar increased risk to develop cancer compared to patients with LGD. A recent publication claims to have investigated the predictive ability of immunohistochemical biomarkers [ 52 ]. However, they reported on samples either obtained from a resection specimen or from cases and controls without follow-up.…”

Section: Discussionmentioning

confidence: 99%

Use of immunohistochemical biomarkers as independent predictor of neoplastic progression in Barrett's oesophagus surveillance: A systematic review and meta-analysis

et al. 2017

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IntroductionThe low incidence of oesophageal adenocarcinoma (EAC) in Barrett's oesophagus (BE) patients reinforces the need for risk stratification tools to make BE surveillance more effective. Therefore, we have undertaken a systematic review and meta-analysis of published studies on immunohistochemical (IHC) biomarkers in BE to determine the value of IHC biomarkers as neoplastic predictors in BE surveillance.Materials and methodsWe searched MEDLINE, EMBASE, Web of Science, CENTRAL, Pubmed publisher, and Google scholar. All studies on IHC biomarkers in BE surveillance were included. ORs were extracted and meta-analyses performed with a random effects model.Results16 different IHC biomarkers were studied in 36 studies. These studies included 425 cases and 1835 controls. A meta- analysis was performed for p53, aspergillus oryzae lectin (AOL), Cyclin A, Cyclin D and alpha-methylacyl-CoA racemase. Aberrant p53 expression was significantly associated with an increased risk of neoplastic progression with an OR of 3.18 (95% CI 1.68 to 6.03). This association was confirmed for both non-dysplastic BE and BE with low-grade dysplasia (LGD). Another promising biomarker to predict neoplastic progression was AOL, with an OR of 3.04 (95% CI 2.05 to 4.49).DiscussionUse of p53 IHC staining may improve risk stratification in BE surveillance. Aberrant p53 expression in BE patients appeared to be associated with a significantly increased risk of neoplastic progression for both non-dysplastic and LGD BE patients.

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“…Furthermore, telomere shortening of epithelial cells has been shown in Barrett's esophagus and adenocarcinoma in relation to the degree of histological atypia, particularly with LOH-positive cases [25]. So far, in practice and according to a meta-analysis, LOH or a mutation of p53, and an increased level of the Ki-67 labeling index for hyperproliferation, are proposed as reliable biomarkers that predict the risk of malignant progression in Barrett's esophagus [26].…”

Section: Gerd-barrett's Esophagus (Mucosal Remodeling)-adenocarcinomamentioning

confidence: 99%

Proposal for an Organ-Specific Chronic Inflammation–Remodeling–Carcinoma Sequence

Okayasu

Ichinoe

Yoshida

2019

Gastrointestinal Disorders

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An organ-specific chronic inflammation-remodeling-carcinoma sequence has been proposed, mainly for the alimentary tract. As representative diseases, gastroesophageal reflux disease, chronic gastritis and inflammatory bowel disease (ulcerative colitis and Crohn's disease of the colitis type) were adopted for this discussion. Tissue remodeling is such an important part of tumorigenesis in this sequence that an organ-specific chronic inflammation-remodeling-carcinoma sequence has been proposed in detail. Chronic inflammation accelerates the cycle of tissue injury and regeneration; in other words, cell necrosis (or apoptosis) and proliferation result in tissue remodeling in long-standing cases of inflammation. Remodeling encompasses epithelial cell metaplasia and stromal fibrosis, and modifies epithelial-stromal cell interactions. Further, the accumulation of genetic, epigenetic and molecular changes-as well as morphologic disorganization-also occurs during tissue remodeling. The expression of mucosal tissue adapted to chronic inflammatory injury is thought to occur at an early stage. Subsequently, dysplasia and carcinoma develop on a background of remodeling due to continuous, active inflammation. Accordingly, organ-specific chronic inflammation should be ameliorated or well controlled with appropriate monitoring if complete healing is unachievable.

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Meta-analysis of biomarkers predicting risk of malignant progression in Barrett's oesophagus

Abstract: Loss and mutation of p53, and raised level of Ki-67 predicted malignant progression in Barrett's oesophagus.

Cited by 28 publications

References 46 publications

Clinical picture of patients with Barrett’s esophagus and different grades of dysplasia

Clinical picture of patients with Barrett’s esophagus and different grades of dysplasia

Use of immunohistochemical biomarkers as independent predictor of neoplastic progression in Barrett's oesophagus surveillance: A systematic review and meta-analysis

Proposal for an Organ-Specific Chronic Inflammation–Remodeling–Carcinoma Sequence

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