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 K.
AU - Sebo, Thomas J.
AU - Halling, Kevin C.
N1 - Funding Information:
This study was supported by Abbott Molecular (Des Plaine, IL), NIH grants R01CA09704 and CA85992-01, and the Mayo Foundation (Rochester, MN).
Funding Information:
It should be noted that a patent has been filed for the FISH probe set discussed in this study. Dr Halling and Ms Shannon Brankley are listed as inventors on the filed patent. Drs Halling, Kipp, and Wang, and Ms Shannon Brankley have the potential to receive royalties from the sale of this FISH probe set. This study was partially funded by Abbott Molecular, Inc. Dr Larry Morrison and Ms Mona Legator are Abbott Molecular employees. No other authors of this study have potential conflicts of interest regarding any of the products used in this study.
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)
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U2 - 10.1016/j.humpath.2008.02.003
DO - 10.1016/j.humpath.2008.02.003
M3 - Article
C2 - 18602665
AN - SCOPUS:47549114817
SN - 0046-8177
VL - 39
SP - 1128
EP - 1135
JO - Human Pathology
JF - Human Pathology
IS - 8
ER -