Use of immunohistochemical biomarkers as independent predictor of neoplastic progression in Barrett's oesophagus surveillance: A systematic review and meta-analysis

• Published in: PloS one Vol. 12; no. 10; p. e0186305
• Main Authors: Janmaat, Vincent T, van Olphen, Sophie H, Biermann, Katharina E, Looijenga, Leendert H J, Bruno, Marco B, Spaander, Manon C W
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 23.10.2017; Public Library of Science (PLoS)
• Subjects: Aberration; Adenocarcinoma; Analysis; Barrett esophagus; Barrett Esophagus - pathology; Barrett's esophagus; Biological markers; Biology and Life Sciences; Biomarkers; Biomarkers - metabolism; Cancer; Complications and side effects; Cyclin A; Cyclin D; Development and progression; Diagnosis; Dysplasia; Endoscopy; Esophageal cancer; Esophageal Neoplasms - pathology; Esophagus; Gastroenterology; Genetic aspects; Hepatology; Humans; Immunohistochemistry; Medical diagnosis; Medical research; Medicine and Health Sciences; Meta-analysis; p53 Protein; Patients; Physical Sciences; Research and Analysis Methods; Risk; Scientific papers; Search engines; Studies; Surveillance; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0186305

The low incidence of oesophageal adenocarcinoma (EAC) in Barrett's oesophagus (BE) patients reinforces the need for risk stratification tools to make BE surveillance more effective. Therefore, we have undertaken a systematic review and meta-analysis of published studies on immunohistochemical (IHC) biomarkers in BE to determine the value of IHC biomarkers as neoplastic predictors in BE surveillance. We searched MEDLINE, EMBASE, Web of Science, CENTRAL, Pubmed publisher, and Google scholar. All studies on IHC biomarkers in BE surveillance were included. ORs were extracted and meta-analyses performed with a random effects model. 16 different IHC biomarkers were studied in 36 studies. These studies included 425 cases and 1835 controls. A meta- analysis was performed for p53, aspergillus oryzae lectin (AOL), Cyclin A, Cyclin D and alpha-methylacyl-CoA racemase. Aberrant p53 expression was significantly associated with an increased risk of neoplastic progression with an OR of 3.18 (95% CI 1.68 to 6.03). This association was confirmed for both non-dysplastic BE and BE with low-grade dysplasia (LGD). Another promising biomarker to predict neoplastic progression was AOL, with an OR of 3.04 (95% CI 2.05 to 4.49). Use of p53 IHC staining may improve risk stratification in BE surveillance. Aberrant p53 expression in BE patients appeared to be associated with a significantly increased risk of neoplastic progression for both non-dysplastic and LGD BE patients.