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Epithelial Cell Proliferative Activity of Barrett's Esophagus (Methodology and Correlation with Traditional Cancer Risk Markers)

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Abstract

Barrett's esophagus (BE) is a premalignantcondition, due to chronic gastroesophageal reflux.Effective antireflux therapy may diminish cancer risk.To evaluate this option an intermediate marker isneeded. We developed a methodology for measurement ofepithelial cell proliferative activity of Barrett'smucosa as an intermediate marker and correlated theactivity with traditional cancer risk markers and other parameters. Fifty-six patients (21-74 years ofage) with Barrett's esophagus and established acidgastroesophageal reflux were included. Biopsies weretaken from Barrett's mucosa at 3-cm intervals. Reflux was measured by 24-hr pH-metry. Proliferativeactivity was determined using in vitro labeling with5-bromodeoxyuridine and immunohistochemistry and wasexpressed as labeling index (LI). The length of BE correlated with erect acid reflux (P = 0.002).LI in specialized columnar metaplasia was higher than ingastric metaplasia, especially in crypt epithelium (P< 0.05). Multiple regression analysis revealed independent positive correlations for surfaceLI with dysplasia (P = 0.011), distance from theincisors (P = 0.041), and crypt LI (P = 0.000). Crypt LIshowed an independent positive correlation with the length of BE (P = 0.033) and type ofmetaplasia (P = 0.007). In conclusion, epithelial cellproliferative activity of BE correlates with severalknown risk factors for cancer. Proliferative activity is an attractive intermediate marker toevaluate the effects of interventional measures todecrease cancer risk in Barrett's esophagus.

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Authors
  1. F. T. M. Peters
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  2. S. Ganesh
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  3. E. J. Kuipers
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  4. A. De Jager-Krikken
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  5. A. Karrenbeld
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  6. G. Harms
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  7. W. J. Sluiter
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  8. J. Koudstaal
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  9. E. C. Klinkenberg-Knol
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  10. C. B. H. W. Lamers
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  11. J. H. Kleibeuker
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Peters, F.T.M., Ganesh, S., Kuipers, E.J. et al. Epithelial Cell Proliferative Activity of Barrett's Esophagus (Methodology and Correlation with Traditional Cancer Risk Markers). Dig Dis Sci 43, 1501–1506 (1998). https://doi.org/10.1023/A:1018858713965

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