New Barrett's esophagus monitoring method could aid in easier and more precise prognoses

A new technique for sampling and testing cells from Barrett's esophagus (BE) patients could result in earlier and easier identification of patients whose disease has progressed toward cancer or whose disease is at high risk of progressing toward cancer, according to a collaborative study by investigators at Case Western Reserve University and Johns Hopkins Kimmel Cancer Center (JHKCC).

Published in the journal Gastroenterology, the findings show the combination of esophageal "brushing" with a massively parallel sequencing method can provide an accurate assessment of the stages of BE in patients and detect specific chromosomal alterations, including the presence of esophageal adenocarcinoma (EAC).

This combined approach aims to provide a practical and sensitive molecular-based method that could improve how doctors detect early progression of BE toward cancer and also assess the risks for such progression among patients already diagnosed with early-stage BE.

"The tests that we have for detecting disease progression in patients with BE are inadequate, as shown by BE patients who develop cancer while under medical surveillance," said Amitabh Chak, MD, senior and corresponding author on the study and a professor of medicine at the School of Medicine and gastroenterologist at the University Hospitals Digestive Health Institute. "We also lack accurate means to recognize new BE patients who are at highest risk to progress toward cancer, and who need more intense surveillance."

"Our findings provide the technical means and conceptual basis for an new molecular based approach that could become key to the clinical management of this disease," said Sanford Markowitz, MD, PhD, co-corresponding author, and the Ingalls Professor of Cancer Genetics and Medicine and Distinguished University Professor at the Case Western Reserve School of Medicine and Case Comprehensive Cancer Center (Case CCC), an oncologist at UH Seidman Cancer Center and corresponding author of the study.

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