BIOMARKERS FOR MALIGNANCY ESOPHAGUS IN THE COLUMNAR-LINED

Barrett’s esophagus is an increasingly common disease with a high risk for the development of adenocarcinoma through stages of dysplasia.21, 23 Over the last two decades, the frequency of esophageal adenocarcinoma has increased at a rate in excess of any other cancer in the United States. Adenocarcinomas develop in Barrett’s esophagus at the rate of approximately one cancer per 125 patient-years of follow-up? The annual incidence rate for esophageal cancer in Barrett’s esophagus is approximately 800 per 100,000.55 Detection of dysplasia is imperative to ensure meaningful clinical intervention.2 Histologic determination of dysplasia involves the establishment of uniform criteria.m, 54 Under certain circumstances, however, ambiguity may arise in the pathologic diagnosis of dysplasia. In this context, biomarkers for cell proliferation and malignant transformation may be helpful. They may be of further assistance as intermediate biologic end points in the evolution of chemoprevention trials. This article discusses basic tenets of the cell cycle and how detection of cell abnormalities can be used as biomarkers in Barrett’s esophagus.x,Zs,39 In addition, oncogenes and tumor suppressor genes that are involved in cell proliferation are discussed as potential biomarkers.