TY - JOUR
T1 - Endoscopic mapping and surrogate markers for better surveillance in Barrett esophagus
T2 - A study of 700 biopsy specimens
AU - Bhargava, Parul
AU - Eisen, Glenn M.
AU - Holterman, Daniel A.
AU - Azumi, Norio
AU - Hartmann, Dan Paul
AU - Hanfelt, John J.
AU - Benjamin, Stanley B.
AU - Lippman, Marc E.
AU - Montgomery, Elizabeth A.
PY - 2000/10
Y1 - 2000/10
N2 - Surveillance methods in Barrett esophagus (BE) using light microscopic examination of random biopsy specimens may miss focal dysplasia. In addition, dysplastic foci identified initially may not be relocated subsequently, making chemoprevention studies difficult. By using a special gastroscope, systematic mapping (4-quadrant biopsy specimens at 1-cm intervals) was performed in 22 patients (33 total mappings yielding 700 biopsy specimens). H & E, immunohistochemistry, and DNA ploidy analysis were performed, c-erbB-2 and positive Ki-67 were detected only in dysplastic sites; thus, their detection did not precede morphologically identifiable dysplasia. On the other hand, aneuploidy and p53 were detected in dysplastic and nondysplastic areas, p53 was correlated with dysplasia, and S-phase narrowly missed correlation, while aneuploidy was not correlated. PCNA and bcl-2 were ubiquitous, limiting their usefulness. On second maps, epithelial type was reidentified with 81% accuracy. A significant correlation was found between p53 and dysplasia. Sites of dysplasia and abnormal biomarkers could be relocated accurately by using endoscopic mapping. Therefore, mapping combined with biomarker studies may provide better surveillance and serve as a useful technique in chemoprevention studies.
AB - Surveillance methods in Barrett esophagus (BE) using light microscopic examination of random biopsy specimens may miss focal dysplasia. In addition, dysplastic foci identified initially may not be relocated subsequently, making chemoprevention studies difficult. By using a special gastroscope, systematic mapping (4-quadrant biopsy specimens at 1-cm intervals) was performed in 22 patients (33 total mappings yielding 700 biopsy specimens). H & E, immunohistochemistry, and DNA ploidy analysis were performed, c-erbB-2 and positive Ki-67 were detected only in dysplastic sites; thus, their detection did not precede morphologically identifiable dysplasia. On the other hand, aneuploidy and p53 were detected in dysplastic and nondysplastic areas, p53 was correlated with dysplasia, and S-phase narrowly missed correlation, while aneuploidy was not correlated. PCNA and bcl-2 were ubiquitous, limiting their usefulness. On second maps, epithelial type was reidentified with 81% accuracy. A significant correlation was found between p53 and dysplasia. Sites of dysplasia and abnormal biomarkers could be relocated accurately by using endoscopic mapping. Therefore, mapping combined with biomarker studies may provide better surveillance and serve as a useful technique in chemoprevention studies.
KW - Barrett
KW - Bcl-2
KW - C-erbB-2
KW - DNA ploidy
KW - Endoscopic mapping
KW - Ki-67
KW - MIB-1
KW - Markers
KW - PCNA
KW - Prospective
KW - p53
UR - http://www.scopus.com/inward/record.url?scp=0034425040&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034425040&partnerID=8YFLogxK
U2 - 10.1309/93WG-ERRB-PN57-C15A
DO - 10.1309/93WG-ERRB-PN57-C15A
M3 - Article
C2 - 11026101
AN - SCOPUS:0034425040
SN - 0002-9173
VL - 114
SP - 552
EP - 563
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 4
ER -