Mutational load may predict risk of progression in patients with Barrett's oesophagus and indefinite for dysplasia: a pilot study

BMJ Open Gastroenterology
Arvind J TrindadeRebecca M Thomas

Abstract

Mutational load (ML) has been shown to help risk-stratify those that may progress from non-dysplastic Barrett's oesophagus (BE) to dysplastic disease. Management of patients with BE and indefinite for dysplasia (BE-IND) is challenging and risk stratification tools are lacking. The aim of this pilot study is to evaluate the utility of ML for risk stratification in patients with BE-IND. This is a single-centre, retrospective pilot study evaluating ML quantification in patients with BE-IND. Histology at follow-up endoscopy at least 1 year after the baseline endoscopy was used to determine if a patient progressed to low or high dysplasia. The ML levels were then compared among patients who progressed to dysplasia versus those who did not. Thirty-five patients who met the inclusion criteria were identified, and seven met the exclusion criteria. Twenty-eight patients were analysed, of whom eight progressed to low-grade dysplasia (6) and high-grade dysplasia (2). Seven of these eight patients had some level of genomic instability detected in their IND biopsy (ML ≥0.5). Ten of the 20 (50%) who did not progress had no ML level. At an ML cut-off above 1.5, the risk of progression to high-grade dysplasia was 33% vs 0% (p=0.005), with a se...Continue Reading

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Citations

May 10, 2020·Current Gastroenterology Reports·Ariel E WattsNicholas J Shaheen
May 13, 2021·Gastrointestinal Endoscopy·Amrit K Kamboj, Cadman L Leggett

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Methods Mentioned

BETA
biopsies
biopsy
electrophoresis
flow cytometry

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