Functional single-nucleotide polymorphism of epidermal growth factor is associated with the development of Barrett's esophagus and esophageal adenocarcinoma

• Published in: Journal of human genetics Vol. 57; no. 1; pp. 26 - 32
• Main Authors: Menke, Vivianda, Pot, Raymond G J, Moons, Leon M G, van Zoest, Katinka P M, Hansen, Bettina, van Dekken, Herman, Siersema, Peter D, Kusters, Johannes G, Kuipers, Ernst J
• Format: Journal Article
• Language: English
• Published: England 01.01.2012
• Subjects: Adenocarcinoma - genetics; Adenocarcinoma - pathology; Barrett Esophagus - genetics; Barrett Esophagus - pathology; Cohort Studies; Epidermal Growth Factor - genetics; Esophageal Neoplasms - genetics; Esophageal Neoplasms - pathology; Esophagitis, Peptic - genetics; Female; Genetic Association Studies; Genetic Predisposition to Disease; Humans; Immunohistochemistry; Logistic Models; Male; Middle Aged; Polymorphism, Single Nucleotide - genetics; Receptor, Epidermal Growth Factor - genetics; Sex Characteristics
• ISSN: 1434-5161; 1435-232X
• DOI: 10.1038/jhg.2011.124

Reflux esophagitis (RO) and Barrett's esophagus (BO) can cause esophageal adenocarcinoma (OAC). The esophageal mucosa in the RO-BO-OAC cascade is chronically exposed to gastro-esophageal reflux. Epidermal growth factor (EGF) has an important role in the protection and repair of mucosal damage, and non-physiologic levels are associated with gastrointestinal tumors. The aim is to determine the functional effect of EGF gene polymorphisms on RO, BO and OAC development. A cohort of 871 unrelated Dutch Caucasians consisted of 198 healthy controls, 298 RO patients, 246 BO patients and 129 OAC patients. The frequency of the EGF-production-associated 5'UTR A+61G polymorphism was determined in these four groups. EGF immunohistochemistry was performed on BO biopsies. EGF expression was significantly lower in the G/G genotype compared with the A/G (P=0.008) and A/A (P=0.002) group. The G/G genotype was significantly more prevalent in RO (odds ratios (OR)=2.6; 95% confidence intervals (95% CI): 1.3-5.2), BO (OR=3.0; 95% CI: 1.5-6.2) and OAC (OR=4.1; 95% CI: 1.8-9.7) than in controls. The G allele is associated with reduced EGF expression and increased risk for RO, BO and OAC development. This indicates that reduced mucosal protection resulting from genetically decreased EGF expression enhances esophageal tumor development.