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Stepwise radical endoscopic resection of the complete Barrett's esophagus with early neoplasia successfully eradicates pre-existing genetic abnormalities
- Source :
- American journal of gastroenterology, 102(9), 1853-1861. Springer Nature
- Publication Year :
- 2007
-
Abstract
- OBJECTIVES: Malignant transformation of Barrett's mucosa is associated with the accumulation of genetic alterations. Stepwise radical endoscopic resection of the Barrett's segment with early neoplasia is a promising new treatment resulting in complete re-epithelialization of the esophagus with neosquamous epithelium. It is unknown whether radical resection also eradicates genetic abnormalities. The aim of this study was to prospectively evaluate whether genetic abnormalities as found in the Barrett's segment before radical resection are effectively eradicated and absent in the neosquamous epithelium. METHODS: Nine patients with early neoplasia who successfully underwent radical resection were included. Immunohistochemistry (IHC) was performed to assess p53 protein overexpression. DNA fluorescent in-situ hybridization was (DNA-FISH) performed for evaluation of numerical abnormalities of chromosomes 1 and 9, and losses of p16 and p53. Immunohistochemistry and DNA-FISH were performed on endoscopic resection specimens of the neoplasia and on follow-up biopsies of the neosquamous epithelium. RESULTS: DNA-FISH and IHC showed alterations in the pretreatment samples of all patients. All showed aneusomy of chromosome 1 and 9. Loss of p16 and p53 were seen in 6 and 8 patients. IHC showed intense p53 nuclear staining in seven patients. Post-treatment biopsies showed neosquamous epithelium with a normal diploid signal count for all DNA-FISH probes and normal IHC stainings in all patients. CONCLUSIONS: Radical resection of Barrett's esophagus with early neoplasia successfully eradicates pre-existing genetic abnormalities and results in neosquamous epithelium without these genetic abnormalities
- Subjects :
- medicine.medical_specialty
Esophageal Neoplasms
Endoscopic surgery
macromolecular substances
Adenocarcinoma
digestive system
Barrett Esophagus
Biopsy
medicine
Humans
Endoscopic resection
Esophagus
In Situ Hybridization, Fluorescence
Chromosome Aberrations
Hepatology
medicine.diagnostic_test
Esophageal disease
business.industry
Genes, p16
Gastroenterology
medicine.disease
Immunohistochemistry
digestive system diseases
Surgery
surgical procedures, operative
medicine.anatomical_structure
Chromosomes, Human, Pair 1
Barrett's esophagus
Esophagoscopy
Tumor Suppressor Protein p53
Premalignant lesion
Radical resection
business
Chromosomes, Human, Pair 9
Precancerous Conditions
Subjects
Details
- ISSN :
- 00029270
- Volume :
- 102
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The American journal of gastroenterology
- Accession number :
- edsair.doi.dedup.....9d5984e1303e8088ef834f16208990ad