PMID- 18076737
OWN - NLM
STAT- MEDLINE
DCOM- 20080313
LR  - 20080110
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 103
IP  - 1
DP  - 2008 Jan
TI  - Buried Barrett's epithelium following photodynamic therapy shows reduced crypt 
      proliferation and absence of DNA content abnormalities.
PG  - 38-47
AB  - OBJECTIVES: Photodynamic therapy (PDT) is increasingly used for the treatment of 
      patients with Barrett's esophagus (BE) with dysplasia or early carcinoma. 
      Post-PDT, some patients show residual BE either exposed to the luminal surface 
      (nonburied) or buried underneath reepithelialized squamous mucosa (buried BE). 
      Buried BE may be a serious clinical problem since it can go unnoticed during 
      surveillance endoscopies. The neoplastic potential of buried BE is poorly 
      understood. The aim of this study was to evaluate the biological characteristics 
      of nonburied and buried BE in patients treated with PDT. METHODS: Twelve patients 
      selected from a cohort of 52 BE patients who received PDT for high-grade 
      dysplasia or intramucosal adenocarcinoma were used for this study because they 
      all had both pre- and post-PDT (nonburied), and post-PDT buried, BE biopsies, 
      without dysplasia, available for analysis. The biopsies were immunostained for 
      Ki-67, p53, cyclin D1, bcl-2, TGF-alpha, EGFR, and AMACR. High fidelity DNA 
      histograms were obtained by image cytometry analysis of Feulgen stained slides, 
      and used to determine peak DNA index (DI), DNA heterogeneity, and 5N exceeding 
      rate (5NER). Comparisons were made between pre-PDT nonburied BE and post-PDT 
      nonburied and buried BE. RESULTS: Pre-PDT BE showed an elevated Ki-67 crypt 
      proliferation rate (43.3%) and p53, bcl-2, TGF-alpha, and EGFR positivity in 8%, 
      25%, 75%, and 25% of cases, respectively. Cyclin D1 and AMACR were negative in 
      all cases. High fidelity DNA histograms showed mild aneuploidy in 73% of cases. 
      Post-PDT buried BE showed a significantly lower Ki-67 crypt proliferation rate 
      (29.9%) in comparison to nonburied BE, in both pre- PDT (43.3%) and post-PDT 
      (44.4%) biopsies (P < 0.05), but similar rates of positivity for the other 
      peptide markers. In contrast to pre-PDT nonburied BE biopsies, high fidelity DNA 
      histograms revealed that none of the buried BE (0%), and only 2/9 (11%) nonburied 
      BE post-PDT, showed aneuploidy. CONCLUSIONS: Pre-PDT nonburied BE, without 
      dysplasia, shows elevated crypt proliferation and mild, but frequent, DNA content 
      abnormalities. Post-PDT, nonburied BE shows persistently elevated crypt 
      proliferation, but significantly less frequent DNA content abnormalities, whereas 
      buried BE shows decreased crypt proliferation and normal DNA content profile. 
      These results suggest that post-PDT buried BE may have a lower neoplastic 
      potential than pre-PDT BE.
FAU - Hornick, Jason L
AU  - Hornick JL
AD  - Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 
      02115, USA.
FAU - Mino-Kenudson, Mari
AU  - Mino-Kenudson M
FAU - Lauwers, Gregory Y
AU  - Lauwers GY
FAU - Liu, Weitian
AU  - Liu W
FAU - Goyal, Raj
AU  - Goyal R
FAU - Odze, Robert D
AU  - Odze RD
LA  - eng
GR  - DK62867/DK/NIDDK NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20071211
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (Ki-67 Antigen)
RN  - 0 (Photosensitizing Agents)
RN  - 136601-57-5 (Cyclin D1)
RN  - 9007-49-2 (DNA)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Barrett Esophagus/*drug therapy/genetics/pathology
MH  - Biopsy
MH  - Cell Proliferation/*drug effects
MH  - Cyclin D1/metabolism
MH  - DNA/*analysis
MH  - Endoscopy, Gastrointestinal
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunohistochemistry
MH  - Intestinal Mucosa/drug effects/metabolism/pathology
MH  - Ki-67 Antigen/metabolism
MH  - Male
MH  - Middle Aged
MH  - Photochemotherapy/*methods
MH  - Photosensitizing Agents/*therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2007/12/14 09:00
MHDA- 2008/03/14 09:00
CRDT- 2007/12/14 09:00
PHST- 2007/12/14 09:00 [pubmed]
PHST- 2008/03/14 09:00 [medline]
PHST- 2007/12/14 09:00 [entrez]
AID - AJG1560 [pii]
AID - 10.1111/j.1572-0241.2007.01560.x [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2008 Jan;103(1):38-47. doi: 10.1111/j.1572-0241.2007.01560.x. 
      Epub 2007 Dec 11.