Use of immunohistochemical biomarkers as independent predictor of neoplastic progression in Barrett's oesophagus surveillance: A systematic review and meta-analysis

Vincent T Janmaat, Sophie H van Olphen, Katharina E Biermann, Leendert H J Looijenga, Marco B Bruno, Manon C W Spaander

Research output: Contribution to journalReview articlepeer-review

Abstract

INTRODUCTION: The low incidence of oesophageal adenocarcinoma (EAC) in Barrett's oesophagus (BE) patients reinforces the need for risk stratification tools to make BE surveillance more effective. Therefore, we have undertaken a systematic review and meta-analysis of published studies on immunohistochemical (IHC) biomarkers in BE to determine the value of IHC biomarkers as neoplastic predictors in BE surveillance.

MATERIALS AND METHODS: We searched MEDLINE, EMBASE, Web of Science, CENTRAL, Pubmed publisher, and Google scholar. All studies on IHC biomarkers in BE surveillance were included. ORs were extracted and meta-analyses performed with a random effects model.

RESULTS: 16 different IHC biomarkers were studied in 36 studies. These studies included 425 cases and 1835 controls. A meta- analysis was performed for p53, aspergillus oryzae lectin (AOL), Cyclin A, Cyclin D and alpha-methylacyl-CoA racemase. Aberrant p53 expression was significantly associated with an increased risk of neoplastic progression with an OR of 3.18 (95% CI 1.68 to 6.03). This association was confirmed for both non-dysplastic BE and BE with low-grade dysplasia (LGD). Another promising biomarker to predict neoplastic progression was AOL, with an OR of 3.04 (95% CI 2.05 to 4.49).

DISCUSSION: Use of p53 IHC staining may improve risk stratification in BE surveillance. Aberrant p53 expression in BE patients appeared to be associated with a significantly increased risk of neoplastic progression for both non-dysplastic and LGD BE patients.

Original languageEnglish
Pages (from-to)e0186305
JournalPloS one
Volume12
Issue number10
DOIs
Publication statusPublished - 2017
Externally publishedYes

Keywords

  • Barrett Esophagus/pathology
  • Biomarkers/metabolism
  • Esophageal Neoplasms/pathology
  • Humans
  • Immunohistochemistry

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