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Ann Thorac Surg 1994;57:598-603
© 1994 The Society of Thoracic Surgeons

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Articles

Potential application of p53 as an intermediate biomarker in Barrett's esophagus

Departments of Surgery and Biology, West Virginia University School of Medicine, Morgantown, West Virginia USA

^_* Address reprint requests to Dr Jones, Department of Surgery, West Virginia University, Health Sciences Center North, PO Box 9238, Morgantown, WV 26506-9238.

Diagnosis of the neoplastic progression in Barrett's esophagus using the histologic classification of dyspiasia is frequently difficult. The tumor suppressor protein p53, when mutated, confers a promoter effect on cell growth. The purpose of this study was to evaluate the applicability of p53 as an intermediate biomarket of malignancy in Barrett's esophagus. Archival analysis of 100 biopsy specimens of Barrett's esophagus and 10 esophageal adenocarcinomas were compared with 35 chronic esophagitis biopsy specimens. Immunocytochemistry using an anti-p53 monoclonal antibody was performed and elevated immunoreactivity quantitated microscopically. Data were analyzed using a logistic regression model. Significant p53 immunoreactivity occurred as follows: chronic esophagitis (0%), Barrett's esophagus without dysplasia (10%), with low-grade dysplasia (60%), with high-grade dysplasia (100%), and adenocarcinoma (70%). All cases of Barrett's esophagus were significantly immunoreactive when compared with the chronic esophagitis cases (p = 0.001). There was an increase in p53 immunoreactivity as the histologic classification progressed toward adenocarcinoma (p = 0.001). Progression to high-grade dysplasia may be predicted based on p53 immunoreactivity. These findings suggest a role for p53 as an intermediate biomarker in Barrett's esophagus.

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