Biomarker studies in reversed Barrett's esophagus.
OBJECTIVE
The purpose of this study was to use biomarkers to assess for cancer risk in Barrett's esophagus patients with either squamous islands or complete reversal of their intestinal metaplasia to squamous epithelium.


METHODS
The biomarkers included proliferation characteristic using Ki-67, p53 abnormalities using immunohistochemical methods with two antibodies, DO-1 and DO-7, and ornithine decarboxylase (ODC) activity.


RESULTS
Eleven patients had complete reversal produced by a combination of acid suppression and thermal injury (multipolar electrocoagulation). Ki-67 staining was indistinguishable from that of normal squamous esophageal epithelium, i.e., basal layer staining only. All 11 cases were negative for p53. ODC activity was low and in the range for normal squamous epithelium. Fourteen patients had squamous islands (partial reversal) after prolonged proton pump inhibitor therapy. Multilayer Ki-67 staining occurred in nine cases (64%), and six (43%) had areas of positive p53 staining.


CONCLUSIONS
Initial biomarker studies suggest that completely reversed squamous epithelium is biologically similar to normal squamous epithelium and of low cancer risk. In contrast, partial reversal, manifest as squamous islands, is accompanied by biomarker abnormalities.
Garewal
H
H
Section of Hematology-Oncology, VA Medical Center and University of Arizona Health Sciences Center, Tucson 85723, USA.
Ramsey
L
L
Sharma
P
P
Kraus
K
K
Sampliner
R
R
Fass
R
R
D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D004564:Electrocoagulation; D004848:Epithelium / Q000473:pathology; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D016158:Genes, p53; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008875:Middle Aged; D009154:Mutation; D009853:Omeprazole / Q000627:therapeutic use; D009955:Ornithine Decarboxylase / Q000378:metabolism; D054328:Proton Pump Inhibitors; D012307:Risk Factors
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D054328:Proton Pump Inhibitors; D009955:Ornithine Decarboxylase; D009853:Omeprazole