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Aberrant p53 protein expression is associated with an increased risk of neoplastic progression in patients with Barrett's oesophagus

  • 0Department of Gastroenterology and Hepatology, Erasmus University Medical Center, , Rotterdam, The Netherlands.
Gut +

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December 22, 2012

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December 22, 2012

View abstract on PubMed

Summary

This summary is machine-generated.

Aberrant p53 protein expression predicts neoplastic progression in Barrett's oesophagus (BO) more effectively than low-grade dysplasia (LGD) alone. This finding improves risk stratification for patients with BO.

Area Of Science

  • Gastroenterology
  • Oncology
  • Molecular Pathology

Background

  • Surveillance for Barrett's oesophagus (BO) is debated due to low neoplastic progression rates and limited risk stratification tools.
  • Low-grade dysplasia (LGD) is the current standard for predicting progression but has low predictive value.

Purpose Of The Study

  • To evaluate the utility of p53 immunohistochemistry for predicting neoplastic progression in patients with BO.
  • To compare the predictive power of p53 expression with histological LGD diagnosis.

Main Methods

  • A case-control study was conducted within a prospective cohort of 720 BO patients.
  • P53 protein expression was assessed via immunohistochemistry in over 12,000 biopsies from 635 patients.
  • Pathologists blinded to outcomes scored p53 expression.

Main Results

  • Neoplastic progression (high-grade dysplasia or oesophageal adenocarcinoma) occurred in 8% of patients.
  • P53 overexpression increased progression risk (adjusted RR 5.6), while p53 loss showed a higher risk (adjusted RR 14.0).
  • Concurrent aberrant p53 expression with LGD increased positive predictive value to 33% from 15% for LGD alone.

Conclusions

  • Aberrant p53 protein expression is a significant risk factor for neoplastic progression in BO.
  • P53 immunohistochemistry appears to be a more potent predictor of neoplastic progression than LGD histology.

Keywords:

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