Document Detail


A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus.
MedLine Citation:
PMID:  18602665     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
New detection methods with prognostic power are needed for early identification of dysplasia and esophageal adenocarcinoma (EA) in patients with Barrett's esophagus (BE). This study assessed the relative sensitivity and specificity of conventional cytology, DNA ploidy analysis with digital image analysis (DIA), and fluorescence in situ hybridization (FISH) for the detection of dysplasia and adenocarcinoma in endoscopic brushing specimens from 92 patients undergoing endoscopic surveillance for BE. FISH used probes to 8q24 (C-MYC), 9p21 (P16), 17q12 (HER2), and 20q13. Four-quadrant biopsies taken every centimeter throughout visible Barrett's mucosa were used as the gold standard. The sensitivity of cytology, DIA, and FISH for low-grade dysplasia was 5%, 5%, and 50%, respectively; for high-grade dysplasia (HGD), 32%, 45%, and 82%, respectively; and for EA, 45%, 45%, and 100%, respectively. FISH was more sensitive (P < .05) than cytology and DIA for low-grade dysplasia, HGD, and EA. The specificity of cytology, DIA, and FISH among patients (n = 14) with tissue showing only benign squamous mucosa was 93%, 86%, and 100% (P = .22), respectively. All patients with a polysomic FISH result had HGD and/or EA within 6 months (n = 33). There was a significant difference between FISH categories (negative, 9p21 loss, gain of a single locus, and polysomy) for progression to HGD/EA (P < .001). These findings suggest that FISH has high sensitivity for the detection of dysplasia and EA in BE patients, with the power to stratify patients by FISH abnormality for progression to HGD/EA. Additional studies are needed to further evaluate the clinical use of FISH.
Authors:
Emily G Barr Fritcher; Shannon M Brankley; Benjamin R Kipp; Jesse S Voss; Michael B Campion; Larry E Morrison; Mona S Legator; Lori S Lutzke; Kenneth K Wang; Thomas J Sebo; Kevin C Halling
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-07-07
Journal Detail:
Title:  Human pathology     Volume:  39     ISSN:  1532-8392     ISO Abbreviation:  Hum. Pathol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-08-28     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1128-35     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis*,  etiology
Adult
Aged
Aged, 80 and over
Barrett Esophagus / complications*
Biopsy, Needle
Cytodiagnosis
DNA, Neoplasm / analysis,  genetics
Esophageal Neoplasms / diagnosis*,  etiology
Esophagoscopy
Humans
In Situ Hybridization, Fluorescence
Middle Aged
Ploidies
Precancerous Conditions / diagnosis*,  etiology
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
CA85992-01/CA/NCI NIH HHS; R01 CA097048/CA/NCI NIH HHS; R01 CA097048-01/CA/NCI NIH HHS; R01 CA111603/CA/NCI NIH HHS; R01 CA111603-01A1/CA/NCI NIH HHS; R01CA09704/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/DNA, Neoplasm
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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