Aurora-A overexpression as an early marker of reflux-related columnar mucosa and Barrett's oesophagus.
BACKGROUND
The development of oesophageal adenocarcinoma is generally closely associated with the presence of a specialised intestinal-type epithelium such as that found in Barrett's oesophagus (BO). A particular histological condition is when the distal oesophagus showing cardiac and/or fundic mucosa without intestinal metaplasia cannot be defined as 'Barrett's mucosa' [condition that we call 'columnar-lined oesophagus' (CLO)] and up till now, there has been no agreement in literature about the management of this condition. Aurora-A overexpression leads to centrosome amplification, chromosomal instability and aneuploidy in mammalian cells.


METHODS
A prospective study was carried out on 28 consecutive patients who presented columnar mucosa above the gastro-oesophageal junction (GOJ) at endoscopy. As controls, two more biopsies were obtained, one on the normal-appearing squamous oesophagus above the GOJ, as far as possible from the columnar mucosa (controls A), and one taken 1 cm below the GOJ (controls B). The Aurora-A and p53 expression levels were analysed respectively by Quantitative Real Time PCR and immunohistochemistry.


RESULTS
Twelve patients were affected by BO (43%) while the other 16 patients (57%) had a CLO. Nine of 28 (32%) cases were focally positive for p53 immunostaining. All the BO/CLO samples were positive for the Aurora-A transcript with regard to controls. Furthermore, 13 of 28 (46%) cases showed overexpression (above the median for the whole group).


CONCLUSIONS
Due to the low number of cases, we are not at present able to state that statistically significant quantitative differences in Aurora-A messenger RNA expression exist between CLO and BO cases with and without dysplasia and p53-positive immunostaining. Further studies on a larger number of cases with a follow-up period are necessary in order to establish the risk of progression and the correct management of these subjects.
Agnese
V
V
Section of Medical Oncology, Department of Surgery and Oncology, Università di Palermo, Italy.
Cabibi
D
D
Calcara
D
D
Terrasi
M
M
Pantuso
G
G
Fiorentino
E
E
Intrivici
C
C
Colucci
G
G
Aragona
F
F
Gebbia
N
N
Bazan
V
V
Russo
A
A
D000230:Adenocarcinoma / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D000328:Adult; D064127:Aurora Kinases; D001471:Barrett Esophagus / Q000201:enzymology / Q000235:genetics* / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000201:enzymology / Q000235:genetics* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000201:enzymology / Q000473:pathology; D011446:Prospective Studies; D017346:Protein Serine-Threonine Kinases / Q000096:biosynthesis* / Q000235:genetics*
D015415:Biomarkers; D064127:Aurora Kinases; D017346:Protein Serine-Threonine Kinases