The use of imaging and biomarkers in diagnosing Barrett's esophagus and predicting the risk of neoplastic progression

Expert Rev Mol Diagn. 2014 Jun;14(5):575-91. doi: 10.1586/14737159.2014.919856. Epub 2014 May 16.

Abstract

Long-standing gastroesophageal reflux disease can result in transformation of the normal squamous lining of the esophagus into columnar epithelium (with goblet cells). This condition, Barrett's esophagus (BE), is considered a risk factor for esophageal cancer (EAC) and may be the cause of the increased incidence of EAC over the last few decades. Currently, endoscopy with biopsies revealing dysplasia is the best predictor for neoplastic progression in patients with BE. However, the use of more sophisticated imaging techniques and biomarkers with or without histological assessment may be helpful in more accurate prediction of malignant transformation in these patients. New approaches to the evaluation of BE such as epigenetics, miRNA analysis, detection of DNA content abnormalities and loss of heterozygosity have great potential to shed light on the complex gastroesophageal reflux disease -BE-EAC sequence.

Keywords: Barrett’s esophagus; DNA content abnormalities; LOH; biomarkers; dysplasia; endoscopy; epigenetics; esophageal adenocarcinoma; imaging; miRNA.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology
  • Barrett Esophagus / diagnosis*
  • Barrett Esophagus / genetics
  • Barrett Esophagus / pathology
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism*
  • Cell Cycle Proteins / genetics
  • Cell Cycle Proteins / metabolism*
  • Epigenesis, Genetic
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / genetics
  • Esophageal Neoplasms / pathology
  • Humans
  • MicroRNAs / genetics
  • MicroRNAs / metabolism*
  • Optical Imaging
  • Risk Factors

Substances

  • Biomarkers, Tumor
  • Cell Cycle Proteins
  • MicroRNAs