A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus

Emily G. Barr Fritcher, Shannon M. Brankley, Benjamin R. Kipp, Jesse S. Voss, Michael B. Campion, Larry E. Morrison, Mona S. Legator, Lori S. Lutzke, Kenneth Ke Ning Wang, Thomas J. Sebo, Kevin C. Halling

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

New detection methods with prognostic power are needed for early identification of dysplasia and esophageal adenocarcinoma (EA) in patients with Barrett's esophagus (BE). This study assessed the relative sensitivity and specificity of conventional cytology, DNA ploidy analysis with digital image analysis (DIA), and fluorescence in situ hybridization (FISH) for the detection of dysplasia and adenocarcinoma in endoscopic brushing specimens from 92 patients undergoing endoscopic surveillance for BE. FISH used probes to 8q24 (C-MYC), 9p21 (P16), 17q12 (HER2), and 20q13. Four-quadrant biopsies taken every centimeter throughout visible Barrett's mucosa were used as the gold standard. The sensitivity of cytology, DIA, and FISH for low-grade dysplasia was 5%, 5%, and 50%, respectively; for high-grade dysplasia (HGD), 32%, 45%, and 82%, respectively; and for EA, 45%, 45%, and 100%, respectively. FISH was more sensitive (P < .05) than cytology and DIA for low-grade dysplasia, HGD, and EA. The specificity of cytology, DIA, and FISH among patients (n = 14) with tissue showing only benign squamous mucosa was 93%, 86%, and 100% (P = .22), respectively. All patients with a polysomic FISH result had HGD and/or EA within 6 months (n = 33). There was a significant difference between FISH categories (negative, 9p21 loss, gain of a single locus, and polysomy) for progression to HGD/EA (P < .001). These findings suggest that FISH has high sensitivity for the detection of dysplasia and EA in BE patients, with the power to stratify patients by FISH abnormality for progression to HGD/EA. Additional studies are needed to further evaluate the clinical use of FISH.

Original languageEnglish (US)
Pages (from-to)1128-1135
Number of pages8
JournalHuman Pathology
Volume39
Issue number8
DOIs
StatePublished - Aug 2008

Fingerprint

Barrett Esophagus
Ploidies
Fluorescence In Situ Hybridization
Cell Biology
Adenocarcinoma
DNA
Mucous Membrane
Biopsy
Sensitivity and Specificity

Keywords

  • Barrett's esophagus
  • Cytology
  • Dysplasia
  • Esophagus
  • Fluorescence in situ hybridization (FISH)

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus. / Barr Fritcher, Emily G.; Brankley, Shannon M.; Kipp, Benjamin R.; Voss, Jesse S.; Campion, Michael B.; Morrison, Larry E.; Legator, Mona S.; Lutzke, Lori S.; Wang, Kenneth Ke Ning; Sebo, Thomas J.; Halling, Kevin C.

In: Human Pathology, Vol. 39, No. 8, 08.2008, p. 1128-1135.

Research output: Contribution to journalArticle

Barr Fritcher, EG, Brankley, SM, Kipp, BR, Voss, JS, Campion, MB, Morrison, LE, Legator, MS, Lutzke, LS, Wang, KKN, Sebo, TJ & Halling, KC 2008, 'A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus', Human Pathology, vol. 39, no. 8, pp. 1128-1135. https://doi.org/10.1016/j.humpath.2008.02.003
Barr Fritcher, Emily G. ; Brankley, Shannon M. ; Kipp, Benjamin R. ; Voss, Jesse S. ; Campion, Michael B. ; Morrison, Larry E. ; Legator, Mona S. ; Lutzke, Lori S. ; Wang, Kenneth Ke Ning ; Sebo, Thomas J. ; Halling, Kevin C. / A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus. In: Human Pathology. 2008 ; Vol. 39, No. 8. pp. 1128-1135.
@article{84df9fbff15f42f8a34fe0b5bd2f6f13,
title = "A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus",
abstract = "New detection methods with prognostic power are needed for early identification of dysplasia and esophageal adenocarcinoma (EA) in patients with Barrett's esophagus (BE). This study assessed the relative sensitivity and specificity of conventional cytology, DNA ploidy analysis with digital image analysis (DIA), and fluorescence in situ hybridization (FISH) for the detection of dysplasia and adenocarcinoma in endoscopic brushing specimens from 92 patients undergoing endoscopic surveillance for BE. FISH used probes to 8q24 (C-MYC), 9p21 (P16), 17q12 (HER2), and 20q13. Four-quadrant biopsies taken every centimeter throughout visible Barrett's mucosa were used as the gold standard. The sensitivity of cytology, DIA, and FISH for low-grade dysplasia was 5{\%}, 5{\%}, and 50{\%}, respectively; for high-grade dysplasia (HGD), 32{\%}, 45{\%}, and 82{\%}, respectively; and for EA, 45{\%}, 45{\%}, and 100{\%}, respectively. FISH was more sensitive (P < .05) than cytology and DIA for low-grade dysplasia, HGD, and EA. The specificity of cytology, DIA, and FISH among patients (n = 14) with tissue showing only benign squamous mucosa was 93{\%}, 86{\%}, and 100{\%} (P = .22), respectively. All patients with a polysomic FISH result had HGD and/or EA within 6 months (n = 33). There was a significant difference between FISH categories (negative, 9p21 loss, gain of a single locus, and polysomy) for progression to HGD/EA (P < .001). These findings suggest that FISH has high sensitivity for the detection of dysplasia and EA in BE patients, with the power to stratify patients by FISH abnormality for progression to HGD/EA. Additional studies are needed to further evaluate the clinical use of FISH.",
keywords = "Barrett's esophagus, Cytology, Dysplasia, Esophagus, Fluorescence in situ hybridization (FISH)",
author = "{Barr Fritcher}, {Emily G.} and Brankley, {Shannon M.} and Kipp, {Benjamin R.} and Voss, {Jesse S.} and Campion, {Michael B.} and Morrison, {Larry E.} and Legator, {Mona S.} and Lutzke, {Lori S.} and Wang, {Kenneth Ke Ning} and Sebo, {Thomas J.} and Halling, {Kevin C.}",
year = "2008",
month = "8",
doi = "10.1016/j.humpath.2008.02.003",
language = "English (US)",
volume = "39",
pages = "1128--1135",
journal = "Human Pathology",
issn = "0046-8177",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett's esophagus

AU - Barr Fritcher, Emily G.

AU - Brankley, Shannon M.

AU - Kipp, Benjamin R.

AU - Voss, Jesse S.

AU - Campion, Michael B.

AU - Morrison, Larry E.

AU - Legator, Mona S.

AU - Lutzke, Lori S.

AU - Wang, Kenneth Ke Ning

AU - Sebo, Thomas J.

AU - Halling, Kevin C.

PY - 2008/8

Y1 - 2008/8

N2 - New detection methods with prognostic power are needed for early identification of dysplasia and esophageal adenocarcinoma (EA) in patients with Barrett's esophagus (BE). This study assessed the relative sensitivity and specificity of conventional cytology, DNA ploidy analysis with digital image analysis (DIA), and fluorescence in situ hybridization (FISH) for the detection of dysplasia and adenocarcinoma in endoscopic brushing specimens from 92 patients undergoing endoscopic surveillance for BE. FISH used probes to 8q24 (C-MYC), 9p21 (P16), 17q12 (HER2), and 20q13. Four-quadrant biopsies taken every centimeter throughout visible Barrett's mucosa were used as the gold standard. The sensitivity of cytology, DIA, and FISH for low-grade dysplasia was 5%, 5%, and 50%, respectively; for high-grade dysplasia (HGD), 32%, 45%, and 82%, respectively; and for EA, 45%, 45%, and 100%, respectively. FISH was more sensitive (P < .05) than cytology and DIA for low-grade dysplasia, HGD, and EA. The specificity of cytology, DIA, and FISH among patients (n = 14) with tissue showing only benign squamous mucosa was 93%, 86%, and 100% (P = .22), respectively. All patients with a polysomic FISH result had HGD and/or EA within 6 months (n = 33). There was a significant difference between FISH categories (negative, 9p21 loss, gain of a single locus, and polysomy) for progression to HGD/EA (P < .001). These findings suggest that FISH has high sensitivity for the detection of dysplasia and EA in BE patients, with the power to stratify patients by FISH abnormality for progression to HGD/EA. Additional studies are needed to further evaluate the clinical use of FISH.

AB - New detection methods with prognostic power are needed for early identification of dysplasia and esophageal adenocarcinoma (EA) in patients with Barrett's esophagus (BE). This study assessed the relative sensitivity and specificity of conventional cytology, DNA ploidy analysis with digital image analysis (DIA), and fluorescence in situ hybridization (FISH) for the detection of dysplasia and adenocarcinoma in endoscopic brushing specimens from 92 patients undergoing endoscopic surveillance for BE. FISH used probes to 8q24 (C-MYC), 9p21 (P16), 17q12 (HER2), and 20q13. Four-quadrant biopsies taken every centimeter throughout visible Barrett's mucosa were used as the gold standard. The sensitivity of cytology, DIA, and FISH for low-grade dysplasia was 5%, 5%, and 50%, respectively; for high-grade dysplasia (HGD), 32%, 45%, and 82%, respectively; and for EA, 45%, 45%, and 100%, respectively. FISH was more sensitive (P < .05) than cytology and DIA for low-grade dysplasia, HGD, and EA. The specificity of cytology, DIA, and FISH among patients (n = 14) with tissue showing only benign squamous mucosa was 93%, 86%, and 100% (P = .22), respectively. All patients with a polysomic FISH result had HGD and/or EA within 6 months (n = 33). There was a significant difference between FISH categories (negative, 9p21 loss, gain of a single locus, and polysomy) for progression to HGD/EA (P < .001). These findings suggest that FISH has high sensitivity for the detection of dysplasia and EA in BE patients, with the power to stratify patients by FISH abnormality for progression to HGD/EA. Additional studies are needed to further evaluate the clinical use of FISH.

KW - Barrett's esophagus

KW - Cytology

KW - Dysplasia

KW - Esophagus

KW - Fluorescence in situ hybridization (FISH)

UR - http://www.scopus.com/inward/record.url?scp=47549114817&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47549114817&partnerID=8YFLogxK

U2 - 10.1016/j.humpath.2008.02.003

DO - 10.1016/j.humpath.2008.02.003

M3 - Article

VL - 39

SP - 1128

EP - 1135

JO - Human Pathology

JF - Human Pathology

SN - 0046-8177

IS - 8

ER -