Abstract
Background/Aim
Barrett’s esophagus (BE) is a precursor of esophageal adenocarcinoma (EAC). Therefore, an accurate diagnosis of BE is important for the subsequent follow-up and early detection of EAC. However, the definitions of BE have not been standardized worldwide; columnar-lined epithelium (CLE) without intestinal metaplasia (IM) and/or < 1 cm is not diagnosed as BE in most countries. This study aimed to clarify the malignant potential of CLE without IM and/or < 1 cm genetically.
Method
A total of 96 consecutive patients (including nine patients with EAC) who had CLE were examined. Biopsies for CLE were conducted, and patients were divided into those with IM and > 1 cm (Group A) and those without IM and/or < 1 cm (Group B). Malignant potential was assessed using immunochemical staining for p53. Moreover, causative genes were examined using next-generation sequencing (NGS) on ten patients without Helicobacter pylori infection and without atrophic gastritis.
Result
Of the 96 patients, 66 were in Group B. The proportion of carcinoma/dysplasia in Group A was significantly higher than that in Group B (26.7% in Group A and 1.5% in Group B; p < 0.01). However, one EAC patient was found in Group B. In the immunostaining study for non-EAC patients, an abnormal expression of p53 was not observed in Group A, whereas p53 loss was observed in three patients (4.6%) in Group B. In the NGS study, a TP53 mutation was found in Group B.
Conclusion
CLE without IM and/or < 1 cm has malignant potential. This result suggests that patients with CLE as well as BE need follow-up.
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Abbreviations
- BE:
-
Barrett’s esophagus
- CLE:
-
Columnar-lined epithelium
- EAC:
-
Esophageal adenocarcinoma
- IM:
-
Intestinal metaplasia
- SCJ:
-
Squamocolumnar junction
- PVs:
-
Palisade vessels
- LSBE:
-
Long-segment Barrett’s esophagus
- SSBE:
-
Short-segment Barrett’s esophagus
- USSBE:
-
Ultrashort segment Barrett’s esophagus
- NGS:
-
Next-generation sequencing
- SD:
-
Standard deviation
- ESCC:
-
Esophageal squamous cell carcinoma
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K.I. wrote paper. K.O., T.M., Y.H., K.A., T.K., M.N., K.M., H.M., and M.A. designed study and analyzed data. N.A., Y.O., K.S., and D.M. performed endoscopy and analyzed data. J.K., O.Y., M.O., and N.K. study supervision.
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Ishikawa, K., Okimoto, K., Matsumura, T. et al. Comprehensive Analysis of Barrett’s Esophagus: Focused on Carcinogenic Potential for Barrett’s Cancer in Japanese Patients. Dig Dis Sci 66, 2674–2681 (2021). https://doi.org/10.1007/s10620-020-06563-1
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DOI: https://doi.org/10.1007/s10620-020-06563-1