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[DNA cytometric studies of Barrett mucosa]
A Spiethoff1, R Jakobs, W R Martin
1Medizinische Klinik C, Klinikum Ludwigshafen gGmbH. spiethoa@klilu.de
Background:
Barrett's esophagus predisposes to cancer development. The diagnosis of dysplastic precursor lesions is impaired by problems of subjectivity. In the present study, DNA ploidy results of patients with Barrett's esophagus were related to the grade of dysplasia and to the progress of the disease.
Patients And Methods:
In 61 patients with Barrett's esophagus, DNA ploidy was determined by image cytometry on imprints. All biopsies (n = 145) were histologically examined for dysplasia distinguishing between low- and high-grade dysplasia, and dysplasia-negative.
Results:
A significant correlation (p < 0.001) between DNA ploidy and the grade of dysplasia was found, with 81% euploid DNA results in biopsies negative for dysplasia and 86% abnormal DNA patterns in biopsies with high-grade dysplasia. The subgroup of low-grade dysplasia showed a heterogeneous DNA ploidy. It is important to note that nearly 20% of biopsies classified dysplasia-negative contained abnormal single cells or abnormal stemlines regarding DNA content. In several cases, suspect DNA results caused a modified reclassification of dysplasia, and there were cases in which patients negative for dysplasia but positive for abnormal DNA ploidy developed dysplasia later on.
Conclusion:
In patients with Barrett's esophagus, DNA ploidy by image cytometry is a suitable additive method for histological evaluation of dysplasia. It seems to be helpful in identifying patients at risk, perhaps before the development of clear dysplasia.