Background: Barrett's esophagus (BE) is an acquired metaplastic lesion with unpredictable potential for esophageal adenocarcinoma (EAC). Searching for immunohistochemical markers for predicting progression in Barrett's esophagus is of increasing interest. The purpose of this study is to detect early dysplastic changes in patients with BE for better management of diagnosed cases.
Materials & Methods: This retrospective study was carried upon 28 endoscopic biopsies of BE; 6 cases of Barrett's esophagus without dysplasia, 12 cases were Barrett's esophagus with low grade dysplasia and 10 cases with high grade dysplasia. Cases were collected from archives of Pathology Department and Early Cancer Detection Unit (ECDU), Faculty of Medicine, Benha University during the years 2015-2020. IMP3 and P53 immunohistochemichal staining were performed and evaluated for each case.
Results: IMP3 was positive with high expression in 80% of high grade dysplasia cases which was a statistically significant relation between IMP3 expression and grade of dysplasia. P53 was a highly sensitive marker for early dysplastic changes, reporting 100% sensitivity to low grade dysplasia. P53 was also highly specific to high grade dysplasia (100%). IMP3 was found to be highly sensitive to high grade dysplastic changes (90%).
Conclusion: Combination of both markers could be helpful in detection of early dysplastic changes in Barrett's esophagus patients who are at risk of malignancy to start a strict follow up procedures. Both markers together could be useful in detection of high grade dysplasia and rapid intervention to prevent malignant transformation.
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