Abstract | OBJECTIVE: This study aims to compare some validated biomarkers of malignancy (Ki-67, p53, and apoptosis) between 2 groups of patients with Barrett's esophagus (BE) undergoing randomly medical or surgical treatment. BACKGROUND: The treatment of choice to prevent the malignant progression of BE remains controversial. Translational studies using biomarkers associated with the metaplasia- tumor pathway could be useful to provide some information in this regard. METHODS: The study group consisted of 45 patients: 20 under medical treatment with 40 mg/day of proton pump inhibitors (PPIs) and 25 after Nissen fundoplication (NFP). After a median follow-up of 8 years (range, 5-10 years), the values of Ki-67, p53, and apoptosis were analyzed in all patients before treatment (n = 45) and then 1 year (n = 45), 3 years (n = 45), 5 years (n = 45), and 10 years (n = 25) afterwards in both groups of treatment. These values were also analyzed in 2 subgroups of patients with successful medical and surgical treatment. RESULTS: Both Ki-67 and p53 remained stable after NFP, whereas they increased progressively in patients under PPIs with statistically significant differences between the 2 groups. Conversely, the apoptotic index increased progressively after NFP and decreased in the patients under PPIs with significant differences at 3, 5, and 10 years of follow-up. On comparing the subgroups of successful treatment the same differences were found. CONCLUSIONS: Barrett's epithelium remains more stable after a long-term follow-up in patients with BE treated surgically than in those under PPIs even in the absence of abnormal rates of acid reflux.
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Authors | Luisa F Martinez de Haro, Angeles Ortiz, Pascual Parrilla, Vicente Munitiz, Carlos M Martinez, Beatriz Revilla, David Ruiz de Angulo, Juan Bermejo, Jose Yélamos, Joaquin Molina |
Journal | Annals of surgery
(Ann Surg)
Vol. 255
Issue 5
Pg. 916-21
(May 2012)
ISSN: 1528-1140 [Electronic] United States |
PMID | 22415421
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers, Tumor
- Ki-67 Antigen
- Proton Pump Inhibitors
- Tumor Suppressor Protein p53
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Topics |
- Adolescent
- Adult
- Aged
- Apoptosis
- Barrett Esophagus
(drug therapy, metabolism, pathology, surgery)
- Biomarkers, Tumor
(metabolism)
- Disease Progression
- Esophageal Neoplasms
(prevention & control)
- Female
- Follow-Up Studies
- Fundoplication
- Humans
- Ki-67 Antigen
(metabolism)
- Male
- Middle Aged
- Proton Pump Inhibitors
(therapeutic use)
- Tumor Suppressor Protein p53
(metabolism)
- Young Adult
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