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 Barrett’s Esophagus

This test identifies genetic abnormalities in patients with Barrett’s esophagus and provides an indication of progression requiring additional procedures and targeted management. Utilizing cytology, immunohistochemistry (IHC), and fluorescence in situ hybridization (FISH) testing on brushings from patients with Barrett’s esophagus, patient chromosomal alterations can be distinguished with high sensitivity and specificity with regard to level of dysplasia and adenocarcinoma.

Indication

At-risk esophageal adenocarcinoma patients or patients who already have Barrett’s esophagus.

SAMPLE METHODS

Esophageal Brushing

  • Brushing specimen in ThinPrep PreservCyt vial (for FISH and IHC)
  • Transport at room temperature in brushing transport kit

Clinical Utility

Our panel of biomarkers that have known associations with dysplastic changes of Barrett’s esophagus includes:

  • AMACR (P504S) – The concentration and activity of this protein has recently been identified as a useful biomarker in detecting dysplasia in ulcerative colitis, Crohn’s disease, and Barrett’s esophagus.
  • p53 – The study of p53 expression by IHC is of interest in Barrett’s esophagus patients with a diagnosis of indefinite for dysplasia or low-grade dysplasia.
  • Ki-67 – IHC staining for MIB-1, the Ki-67 proliferation antigen, appears gradually.
  • ABPH 2.5 – Stains the acidic mucin present in goblet cells.
  • Feulgen Stain – Used for the quantification of chromosomal material or DNA with sufficient resolution to detect the gain or loss of a single large chromosome.
  • Cytology – Imparts a characteristic range of coloration to exfoliative cells, allowing critical examination of nuclei and cytoplasmic components.

FISH: Our FISH panel of biomarkers provides an indication of progression requiring additional procedures and specific management. Utilizing a four-probe panel to detect gains and losses of MYC (8q24), p16 (CDKN2A at 9p21), HER2 (ERBB2 at 17q12), and ZNF217(20q13) associated with higher-risk disease, our Barrett’s FISH panel offers:

  • Differentiation between patients with low-grade dysplasia and high-grade dysplasia.
  • Histology confirmation when results are concordant, and suggests further investigation is needed when results differ from histology.
  • Support for aggressive treatment decisions based on positive test results together with concordant morphology.

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