[Dna ploidy in adenocarcinoma of Barrett's esophagus]

We have studied by flow cytometry the ADN-ploidy of 23 adenocarcinomas developed on Barrett's oesophagus operated at hospital Beaujon between 1982 and 1988. This retrospective study was done on formalin-fixed and paraffin-embedded material. Non dysplastic Barrett's mucosa was diploid in all of the 11 studied cases. Dysplastic mucosa was aneuploid in the 4 studied cases, as were the carcinomas in the same patients. Seven tumors were diploid, and 16 aneuploid. There was no relationship between the aneuploidy and the degree of tumor differentiation. Fourteen of the 15 tumors which invaded the adventitia and only 2 of the 8 tumors which were limited to the muscularis propria were aneuploid. Thirteen of 16 aneuploid and only 2 of 7 diploid tumors had lymph node invasion. Six of the 7 patients with diploid tumor were well 12 to 52 months after surgery. Eleven of the 16 patients with aneuploid tumor died, the remaining 5 were well 12 to 18 months after surgery. The ratio of aneuploid adenocarcinomas developed on Barrett's oesophagus is similar to the ratio observed in other types of solid tumors. The prognosis of adenocarcinoma in Barrett's oesophagus is poor. According to our results, the prognosis of diploid tumors seems to be better than that of aneuploid tumors. In order to determine the value of ADN-ploidy as an independent prognostic criterion, it would be of interest to study a greater number of patients with longer follow-up.