Use of immunohistochemical biomarkers as independent predictor of neoplastic progression in Barrett's oesophagus surveillance
A systematic review and meta-analysis
Introduction: The low incidence of oesophageal adenocarcinoma (EAC) in Barrett's oesophagus (BE) patients reinforces the need for risk stratification tools to make BE surveillance more effective. Therefore, we have undertaken a systematic review and meta-analysis of published studies on immunohistochemical (IHC) biomarkers in BE to determine the value of IHC biomarkers as neoplastic predictors in BE surveillance.
Materials and methods: We searched MEDLINE, EMBASE, Web of Science, CENTRAL, Pubmed publisher, and Google scholar. All studies on IHC biomarkers in BE surveillance were included. ORs were extracted and meta-analyses performed with a random effects model.
Results: 16 different IHC biomarkers were studied in 36 studies. These studies included 425 cases and 1835 controls. A meta-analysis was performed for p53, aspergillus oryzae lectin (AOL), Cyclin A, Cyclin D and alpha-methylacyl-CoA racemase. Aberrant p53 expression was significantly associated with an increased risk of neoplastic progression with an OR of 3.18 (95% CI 1.68 to 6.03). This association was confirmed for both non-dysplastic BE and BE with low-grade dysplasia (LGD). Another promising biomarker to predict neoplastic progression was AOL, with an OR of 3.04 (95% CI 2.05 to 4.49).
Discussion: Use of p53 IHC staining may improve risk stratification in BE surveillance. Aberrant p53 expression in BE patients appeared to be associated with a significantly increased risk of neoplastic progression for both non-dysplastic and LGD BE patients.
|Persistent URL||dx.doi.org/10.1371/journal.pone.0186305, hdl.handle.net/1765/102589|
Janmaat, V.T, van Olphen, S.H, Biermann, K, Looijenga, L.H.J, Bruno, M.J, & Spaander, M.C.W. (2017). Use of immunohistochemical biomarkers as independent predictor of neoplastic progression in Barrett's oesophagus surveillance. PLoS ONE (Vol. 12). doi:10.1371/journal.pone.0186305