title: Changes in gene expression of neo-squamous mucosa after endoscopic treatment for dysplastic Barrett's esophagus and intramucosal adenocarcinoma.
abstract: BACKGROUND
  Endoscopic therapy, including by radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR), is first line treatment for Barrett's esophagus (BE) with high-grade dysplasia (HGD) or intramucosal cancer (IMC) and may be appropriate for some patients with low-grade dysplasia (LGD).
  
  
  OBJECTIVE
  The purpose of this study was to investigate the molecular effects of endotherapy.
  
  
  METHODS
  mRNA expression of 16 genes significantly associated with different BE stages was measured in paired pre-treatment BE tissues and post-treatment neo-squamous biopsies from 36 patients treated by RFA (19 patients, 3 IMC, 4 HGD, 12 LGD) or EMR (17 patients, 4 IMC, 13 HGD). EMR was performed prior to RFA in eight patients. Normal squamous esophageal tissues were from 20 control individuals.
  
  
  RESULTS
  Endoscopic therapy resulted in significant change towards the normal squamous expression profile for all genes. The neo-squamous expression profile was significantly different to the normal control profile for 11 of 16 genes.
  
  
  CONCLUSIONS
  Endotherapy results in marked changes in mRNA expression, with replacement of the disordered BE dysplasia or IMC profile with a more "normal" profile. The neo-squamous mucosa was significantly different to the normal control squamous mucosa for most genes. The significance of this finding is uncertain but it may support continued endoscopic surveillance after successful endotherapy.
authors.affiliation: Gastroesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Angelique
authors.initials: A
authors.lastname: Levert-Mignon
authors.affiliation: Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bourke
authors.affiliation: Gastroesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia; School of Medicine, University of Notre Dame, Sydney, NSW, Australia.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Lord
authors.affiliation: Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Taylor
authors.affiliation: Diagnostic Endoscopy Centre, St Vincent's Clinic, Sydney, NSW, Australia.
authors.forename: Antony R
authors.initials: AR
authors.lastname: Wettstein
authors.affiliation: School of Medicine, University of Notre Dame, Sydney, NSW, Australia; Department of Histopathology, Douglass Hanly Moir Pathology, Sydney, NSW Australia.
authors.forename: Melanie
authors.initials: M
authors.lastname: Edwards
authors.affiliation: Gastroesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Natalia K
authors.initials: NK
authors.lastname: Botelho
authors.affiliation: Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sonson
authors.affiliation: Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Chatura
authors.initials: C
authors.lastname: Jayasekera
authors.affiliation: Gastroesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Fisher
authors.affiliation: Gastroesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia; School of Medicine, University of Notre Dame, Sydney, NSW, Australia.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Thomas
authors.affiliation: Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Medicine, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Finlay
authors.initials: F
authors.lastname: Macrae
authors.affiliation: Department of Surgery, Flinders University, Flinders Medical Centre Bedford Park, SA, Australia; Flinders Centre for Cancer Prevention and Control, Flinders University, Bedford Park, SA, Australia.
authors.forename: Damian J
authors.initials: DJ
authors.lastname: Hussey
authors.affiliation: Department of Surgery, Flinders University, Flinders Medical Centre Bedford Park, SA, Australia; Flinders Centre for Cancer Prevention and Control, Flinders University, Bedford Park, SA, Australia.
authors.forename: David I
authors.initials: DI
authors.lastname: Watson
authors.affiliation: Gastroesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia; School of Medicine, University of Notre Dame, Sydney, NSW, Australia; Diagnostic Endoscopy Centre, St Vincent's Clinic, Sydney, NSW, Australia.
authors.forename: Reginald V
authors.initials: RV
authors.lastname: Lord
keywords: Barrett’s esophagus; endoscopic mucosal resection; esophageal adenocarcinoma; esophageal neoplasms; high-grade dysplasia; radiofrequency ablation