p53 Protein accumulation is a specific marker of malignant potential in Barrett's metaplasia

Dig Dis Sci. 1997 Apr;42(4):697-701. doi: 10.1023/a:1018828207371.

Abstract

Our aim was to determine the sensitivity and specificity of p53 accumulation as a marker of malignant potential in Barrett's metaplasia (BM). One hundred eighty biopsies from 61 patients with BM were evaluated for p53 accumulation by immunohistochemistry. Of 25 patients with LGD, 9 had p53-positive biopsies, and of these 5 (56%) developed HGD/CA, whereas 16 had p53-negative biopsies and none (0%) developed HGD/CA after similar follow-up times (P = 0.0108). As a marker of malignant potential in BM, p53 accumulation has a sensitivity of 100%, specificity of 93%, and a predictive value of a positive test of 0.56, compared to sensitivity of 100%, specificity of 64%, and predictive value of a positive test of 0.2 for a histologic diagnosis of LGD. We conclude that: (1) p53 accumulation is more specific and has better predictive value for subsequent development of HGD/CA than histologic diagnosis of LGD. (2) Patients with LGD and p53-positive biopsies are more likely to develop HGD/CA; therefore, they should be followed up more closely than those with LGD and p53-negative biopsies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Barrett Esophagus / complications
  • Barrett Esophagus / metabolism*
  • Barrett Esophagus / pathology
  • Biomarkers, Tumor / metabolism*
  • Biopsy
  • Carcinoma / diagnosis
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / diagnosis*
  • Esophagus / pathology
  • Humans
  • Immunohistochemistry
  • Metaplasia
  • Precancerous Conditions / metabolism
  • Sensitivity and Specificity
  • Tumor Suppressor Protein p53 / metabolism*

Substances

  • Biomarkers, Tumor
  • Tumor Suppressor Protein p53