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Review
. 2010 Dec 7;16(45):5669-81.
doi: 10.3748/wjg.v16.i45.5669.

Biomarkers in Barrett's esophagus and esophageal adenocarcinoma: predictors of progression and prognosis

Chin-Ann J Ong  1 , Pierre Lao-Sirieix, Rebecca C Fitzgerald
Affiliations
Review

Biomarkers in Barrett's esophagus and esophageal adenocarcinoma: predictors of progression and prognosis

Chin-Ann J Ong et al. World J Gastroenterol. .

Abstract

Barrett's esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett's esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett's esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett's esophagus and EA and to discuss what is required to move the field forward towards clinical application.

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Figures

Figure 1
Figure 1
Transition of squamous epithelium to intestinal metaplasia, dysplasia and adenocarcinoma, with potential useful biomarkers at each stage of the disease. The left-most panel shows normal stratified squamous epithelium. The second panel shows Barrett’s esophagus without dysplasia, with the presence of goblet cells. The third and fourth panels show Barrett’s esophagus with low-grade dysplasia and high-grade dysplasia, whereas the last panel shows adenocarcinoma.
Figure 2
Figure 2
Phases of diagnostic and prognostic biomarker development proposed by the Early Detection Research Network and reporting recommendations for tumor marker prognostic studies before clinical implementation[23,24]. EDRN: Early Detection Research Network; REMARK: Reporting recommendations for tumor marker prognostic studies.
See this image and copyright information in PMC

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