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Comprehensive Analysis of Barrett’s Esophagus: Focused on Carcinogenic Potential for Barrett’s Cancer in Japanese Patients

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Abstract

Background/Aim

Barrett’s esophagus (BE) is a precursor of esophageal adenocarcinoma (EAC). Therefore, an accurate diagnosis of BE is important for the subsequent follow-up and early detection of EAC. However, the definitions of BE have not been standardized worldwide; columnar-lined epithelium (CLE) without intestinal metaplasia (IM) and/or < 1 cm is not diagnosed as BE in most countries. This study aimed to clarify the malignant potential of CLE without IM and/or < 1 cm genetically.

Method

A total of 96 consecutive patients (including nine patients with EAC) who had CLE were examined. Biopsies for CLE were conducted, and patients were divided into those with IM and > 1 cm (Group A) and those without IM and/or < 1 cm (Group B). Malignant potential was assessed using immunochemical staining for p53. Moreover, causative genes were examined using next-generation sequencing (NGS) on ten patients without Helicobacter pylori infection and without atrophic gastritis.

Result

Of the 96 patients, 66 were in Group B. The proportion of carcinoma/dysplasia in Group A was significantly higher than that in Group B (26.7% in Group A and 1.5% in Group B; p < 0.01). However, one EAC patient was found in Group B. In the immunostaining study for non-EAC patients, an abnormal expression of p53 was not observed in Group A, whereas p53 loss was observed in three patients (4.6%) in Group B. In the NGS study, a TP53 mutation was found in Group B.

Conclusion

CLE without IM and/or < 1 cm has malignant potential. This result suggests that patients with CLE as well as BE need follow-up.

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Abbreviations

BE:

Barrett’s esophagus

CLE:

Columnar-lined epithelium

EAC:

Esophageal adenocarcinoma

IM:

Intestinal metaplasia

SCJ:

Squamocolumnar junction

PVs:

Palisade vessels

LSBE:

Long-segment Barrett’s esophagus

SSBE:

Short-segment Barrett’s esophagus

USSBE:

Ultrashort segment Barrett’s esophagus

NGS:

Next-generation sequencing

SD:

Standard deviation

ESCC:

Esophageal squamous cell carcinoma

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, Chiba University Hospital, Inohana 1-8-1, Chiba-City, 260-8670, Japan

    Kentaro Ishikawa, Kenichiro Okimoto, Tomoaki Matsumura, Naoki Akizue, Yuki Ohta, Keiko Saito, Daisuke Maruoka, Makoto Arai, Jun Kato & Naoya Kato

  2. Department of Medical Oncology, Chiba University Hospital, Chiba, Japan

    Kenichiro Okimoto & Makoto Arai

  3. Genome Analysis Center, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan

    Yosuke Hirotsu, Kenji Amemiya, Hitoshi Mochizuki & Masao Omata

  4. Clinical Research Center, Chiba University Hospital, Chiba, Japan

    Daisuke Maruoka

  5. Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan

    Motoi Nishimura & Kazuyuki Matsushita

  6. Department of Molecular Pathology, Graduate School of Medicine, Chiba University Hospital, Chiba, Japan

    Takashi Kishimoto

  7. Graduate School of Medicine, University of Chiba, Chiba, Japan

    Osamu Yokosuka

  8. Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Masao Omata

Authors
  1. Kentaro Ishikawa
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  2. Kenichiro Okimoto
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  3. Tomoaki Matsumura
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  4. Yosuke Hirotsu
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  5. Kenji Amemiya
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  6. Takashi Kishimoto
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  7. Naoki Akizue
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  8. Yuki Ohta
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  9. Keiko Saito
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  10. Daisuke Maruoka
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  11. Motoi Nishimura
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  12. Kazuyuki Matsushita
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  13. Hitoshi Mochizuki
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  14. Makoto Arai
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  15. Jun Kato
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  16. Osamu Yokosuka
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  17. Masao Omata
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  18. Naoya Kato
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Contributions

K.I. wrote paper. K.O., T.M., Y.H., K.A., T.K., M.N., K.M., H.M., and M.A. designed study and analyzed data. N.A., Y.O., K.S., and D.M. performed endoscopy and analyzed data. J.K., O.Y., M.O., and N.K. study supervision.

Corresponding author

Correspondence to Kenichiro Okimoto.

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Conflict of interest

All authors were involved in the final approval of the version of the manuscript submitted and have agreed to be accountable for all aspects of the work. There is no relevant conflict of interest or disclosures, including financial and material support for the research and work in this manuscript.

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Ishikawa, K., Okimoto, K., Matsumura, T. et al. Comprehensive Analysis of Barrett’s Esophagus: Focused on Carcinogenic Potential for Barrett’s Cancer in Japanese Patients. Dig Dis Sci 66, 2674–2681 (2021). https://doi.org/10.1007/s10620-020-06563-1

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  • DOI: https://doi.org/10.1007/s10620-020-06563-1

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