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World J Gastroenterol. Dec 7, 2010; 16(45): 5669-5681
Published online Dec 7, 2010. doi: 10.3748/wjg.v16.i45.5669
Biomarkers in Barrett’s esophagus and esophageal adenocarcinoma: Predictors of progression and prognosis
Chin-Ann J Ong, Pierre Lao-Sirieix, Rebecca C Fitzgerald
Chin-Ann J Ong, Pierre Lao-Sirieix, Rebecca C Fitzgerald, MRC Cancer Cell Unit, Hutchison-MRC Research Centre, Cambridge, CB20XZ, United Kingdom
Author contributions: Ong CAJ, Lao-Sirieix P and Fitzgerald RC performed the literature review, critically analyzed the evidence and wrote the paper.
Correspondence to: Rebecca C Fitzgerald, MD, MRC Cancer Cell Unit, Hutchison-MRC Research Centre, Box 197/ Hills Road, Cambridge, CB20XZ, United Kingdom. rcf@hutchison-mrc.cam.ac.uk
Telephone: +44-1223-763287 Fax: +44-1223-763296
Received: May 27, 2010
Revised: July 28, 2010
Accepted: August 4, 2010
Published online: December 7, 2010
Abstract

Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett’s esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett’s esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett’s esophagus and EA and to discuss what is required to move the field forward towards clinical application.

Keywords: Barrett’s esophagus; Esophageal adenocarcinoma; Esophageal dysplasia; Prognosis