Follow-up on the gamma-glutamyl transpeptidase in patients with severe dysplasia in an area of high incidence of esophageal cancer.
OBJECTIVE
To investigate the clinical value of cytological gamma-glutamyl transpeptidase (gamma-GT) staining in the reduction of the morbidity and mortality of esophageal cancer in an area of China that has a high incidence of esophageal cancer.


METHODS
The results of pathology, cytological examination with gamma-GT staining in 451 patients with severe dysplasia were analyzed and followed-up for 3 years.


RESULTS
At the 1-year follow-up, 17 of 231 patients with positive gamma-GT staining (7.4%) had developed esophageal cancer, but no cancer was detected in 95 patients with negative gamma-GT staining. Among 215 patients who were followed-up for 3 years, the risk of developing cancer in gamma-GT staining positive patients with grade I or II severe dysplasia was 5.7% and 14.3%, respectively. However, esophageal cancer was not found in patients with negative gamma-GT staining or in patients with positive gamma-GT staining who were younger than 40 years.


CONCLUSIONS
These findings suggest that gamma-GT staining can be used as a cancer risk marker of esophageal epithelial dysplasia. Esophageal dysplasia needs to be further categorized according to gamma-GT staining for esophageal cancer prevention, and intervention is required for gamma-GT staining positive patients with severe dysplasia in order to increase the cost-benefit ratio of esophageal cancer prevention.
Li
Jian
J
Gastroenterology & Hepatology Unit, Department of Medicine, The 2nd Affiliated Hospital of Zhengzhou University, Zhengzhou Henan Province, China. jiuwei@163.com
Bai
Jing Xiu
JX
Zhao
Zhi Gou
ZG
Zheng
Peng Yuan
PY
Ma
Jun
J
Guo
Min
M
Liu
Yun Yuan
YY
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002681:China / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000201:enzymology* / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004947:Esophagus / Q000201:enzymology* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000378:metabolism*
D014408:Biomarkers, Tumor; D005723:gamma-Glutamyltransferase