Introduction Barrett’s oesophagus (BE) is considered to be associated with an increased risk of esophageal adenocarcinoma (OAC), but the risk of progression is low and unpredictable. Previous studies have demonstrated a higher risk of progression in BE patients with: low grade dysplasia; segment length >8 cm; a family history of OAC and residual BE post treatment for OAC (surgery, chemoradiotherapy or endoscopic therapy). We and others have previously demonstrated that DNA ploidy abnormalities can act as prognostic biomarkers for the risk of progression to OAC. The aim of this study was to assess DNA ploidy in high risk groups using routine biopsy samples taken at surveillance endoscopy in a clinical setting.

Method Prospective study of patients undergoing routine BE surveillance at three centres. All biopsy samples were dual reported by two expert pathologists. DNA ploidy analysis was undertaken using Image cytometry (ICM) on Formalin Fixed Paraffin Embedded tissue, as previously described.¹All samples were analysed to the same protocol.

Results A total of 51 patients underwent DNA ploidy analysis over a 2 year period. Mean age was 63 years (range 22–86 years), 82% male. Results are shown in Table 1. There was high prevalence of DNA ploidy abnormalities (aneuploidy) in the LGD group at 33%. DNA ploidy abnormalities were not identified in other groups on this study.

Conclusion This study demonstrates the presence of aneuploidy is significantly higher in low grade dysplasia than other high risk clinical groups, with a third of patients displaying genomic instability. DNA ploidy ICM may be useful in routine pathology practice to risk stratify patients with LGD. The role of DNA ploidy in non dysplastic BE with high clinical risk cannot be concluded from this small cohort.

Disclosure of interest None Declared.

References

1. Dunn JM, Mackenzie GD, Oukrif D, et al.Image cytometry accurately detects DNA ploidy abnormalities and predicts late relapse to high grade dysplasia and adenocarcinoma in Barrett–s oesophagus following photodynamic therapy. Br J Cancer2010;102:1608–1617