Academic Journal
Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett's oesophagus surveillance: Individual-level data analysis
| Τίτλος: | Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett's oesophagus surveillance: Individual-level data analysis |
|---|---|
| Συγγραφείς: | Black E. L., Ococks E., Devonshire G., Ng A. W. T., O'Donovan M., Malhotra S., Tripathi M., Ciccarelli FD, Miremadi A., Freeman A., Coles H., Fitzgerald R. C. |
| Συνεισφορές: | E.L. Black, E. Ocock, G. Devonshire, A.W.T. Ng, M. O'Donovan, S. Malhotra, M. Tripathi, F. Ciccarelli, A. Miremadi, A. Freeman, H. Cole, R.C. Fitzgerald |
| Στοιχεία εκδότη: | BMJ Publishing Group |
| Έτος έκδοσης: | 2024 |
| Συλλογή: | The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
| Θεματικοί όροι: | Barrett's metaplasia, Barrett's oesophagu, gastric metaplasia, oesophageal cancer, surveillance, Settore BIOS-08/A - Biologia molecolare |
| Περιγραφή: | Objective Whether gastric metaplasia (GM) of the oesophagus should be considered as Barrett's oesophagus (BO) is controversial. Given concern intestinal metaplasia (IM) may be missed due to sampling, the UK guidelines include GM as a type of BO. Here, we investigated whether the risk of misdiagnosis and the malignant potential of GM warrant its place in the UK surveillance. Design We performed a thorough pathology and endoscopy review to follow clinical outcomes in a novel UK cohort of 244 patients, covering 1854 person years of follow-up. We complemented this with a comparative genomic analysis of 160 GM and IM specimens, focused on early molecular hallmarks of BO and oesophageal adenocarcinoma (OAC). Results We found that 58 of 77 short-segment (<3 cm) GM (SS-GM) cases (75%) continued to be observed as GM-only across a median of 4.4 years of follow-up. We observed that disease progression in GM-only cases and GM+IM cases (cases with reported GM on some occasions, IM on others) was significantly lower than in the IM-only cases (Kaplan-Meier, p=0.03). Genomic analysis revealed that the mutation burden in GM is significantly lower than in IM (p<0.01). Moreover, GM does not bear the mutational hallmarks of OAC, with an absence of associated signatures and driver gene mutations. Finally, we established that GM found adjacent to OAC is evolutionarily distant from cancer. Conclusion SS-GM is a distinct entity from SS-IM and the malignant potential of GM is lower than IM. It is questionable whether SS-GM warrants inclusion in BO surveillance. |
| Τύπος εγγράφου: | article in journal/newspaper |
| Γλώσσα: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/37989565; info:eu-repo/semantics/altIdentifier/wos/WOS:001109636100001; volume:73; issue:5; firstpage:729; lastpage:740; numberofpages:12; journal:GUT; https://hdl.handle.net/2434/1249239 |
| DOI: | 10.1136/gutjnl-2023-330721 |
| Διαθεσιμότητα: | https://hdl.handle.net/2434/1249239 https://doi.org/10.1136/gutjnl-2023-330721 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Αριθμός Καταχώρησης: | edsbas.9F3F2C6F |
| Βάση Δεδομένων: | BASE |
| FullText | Text: Availability: 0 CustomLinks: – Url: https://hdl.handle.net/2434/1249239# Name: EDS - BASE (ns324271) Category: fullText Text: View record from BASE |
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| Header | DbId: edsbas DbLabel: BASE An: edsbas.9F3F2C6F RelevancyScore: 945 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 944.983581542969 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett's oesophagus surveillance: Individual-level data analysis – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Black+E%2E+L%2E%22">Black E. L.</searchLink><br /><searchLink fieldCode="AR" term="%22Ococks+E%2E%22">Ococks E.</searchLink><br /><searchLink fieldCode="AR" term="%22Devonshire+G%2E%22">Devonshire G.</searchLink><br /><searchLink fieldCode="AR" term="%22Ng+A%2E+W%2E+T%2E%22">Ng A. W. T.</searchLink><br /><searchLink fieldCode="AR" term="%22O'Donovan+M%2E%22">O'Donovan M.</searchLink><br /><searchLink fieldCode="AR" term="%22Malhotra+S%2E%22">Malhotra S.</searchLink><br /><searchLink fieldCode="AR" term="%22Tripathi+M%2E%22">Tripathi M.</searchLink><br /><searchLink fieldCode="AR" term="%22Ciccarelli+FD%22">Ciccarelli FD</searchLink><br /><searchLink fieldCode="AR" term="%22Miremadi+A%2E%22">Miremadi A.</searchLink><br /><searchLink fieldCode="AR" term="%22Freeman+A%2E%22">Freeman A.</searchLink><br /><searchLink fieldCode="AR" term="%22Coles+H%2E%22">Coles H.</searchLink><br /><searchLink fieldCode="AR" term="%22Fitzgerald+R%2E+C%2E%22">Fitzgerald R. C.</searchLink> – Name: Author Label: Contributors Group: Au Data: E.L. Black<br />E. Ocock<br />G. Devonshire<br />A.W.T. Ng<br />M. O'Donovan<br />S. Malhotra<br />M. Tripathi<br />F. Ciccarelli<br />A. Miremadi<br />A. Freeman<br />H. Cole<br />R.C. Fitzgerald – Name: Publisher Label: Publisher Information Group: PubInfo Data: BMJ Publishing Group – Name: DatePubCY Label: Publication Year Group: Date Data: 2024 – Name: Subset Label: Collection Group: HoldingsInfo Data: The University of Milan: Archivio Istituzionale della Ricerca (AIR) – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22Barrett's+metaplasia%22">Barrett's metaplasia</searchLink><br /><searchLink fieldCode="DE" term="%22Barrett's+oesophagu%22">Barrett's oesophagu</searchLink><br /><searchLink fieldCode="DE" term="%22gastric+metaplasia%22">gastric metaplasia</searchLink><br /><searchLink fieldCode="DE" term="%22oesophageal+cancer%22">oesophageal cancer</searchLink><br /><searchLink fieldCode="DE" term="%22surveillance%22">surveillance</searchLink><br /><searchLink fieldCode="DE" term="%22Settore+BIOS-08%2FA+-+Biologia+molecolare%22">Settore BIOS-08/A - Biologia molecolare</searchLink> – Name: Abstract Label: Description Group: Ab Data: Objective Whether gastric metaplasia (GM) of the oesophagus should be considered as Barrett's oesophagus (BO) is controversial. Given concern intestinal metaplasia (IM) may be missed due to sampling, the UK guidelines include GM as a type of BO. Here, we investigated whether the risk of misdiagnosis and the malignant potential of GM warrant its place in the UK surveillance. Design We performed a thorough pathology and endoscopy review to follow clinical outcomes in a novel UK cohort of 244 patients, covering 1854 person years of follow-up. We complemented this with a comparative genomic analysis of 160 GM and IM specimens, focused on early molecular hallmarks of BO and oesophageal adenocarcinoma (OAC). Results We found that 58 of 77 short-segment (<3 cm) GM (SS-GM) cases (75%) continued to be observed as GM-only across a median of 4.4 years of follow-up. We observed that disease progression in GM-only cases and GM+IM cases (cases with reported GM on some occasions, IM on others) was significantly lower than in the IM-only cases (Kaplan-Meier, p=0.03). Genomic analysis revealed that the mutation burden in GM is significantly lower than in IM (p<0.01). Moreover, GM does not bear the mutational hallmarks of OAC, with an absence of associated signatures and driver gene mutations. Finally, we established that GM found adjacent to OAC is evolutionarily distant from cancer. Conclusion SS-GM is a distinct entity from SS-IM and the malignant potential of GM is lower than IM. It is questionable whether SS-GM warrants inclusion in BO surveillance. – Name: TypeDocument Label: Document Type Group: TypDoc Data: article in journal/newspaper – Name: Language Label: Language Group: Lang Data: English – Name: NoteTitleSource Label: Relation Group: SrcInfo Data: info:eu-repo/semantics/altIdentifier/pmid/37989565; info:eu-repo/semantics/altIdentifier/wos/WOS:001109636100001; volume:73; issue:5; firstpage:729; lastpage:740; numberofpages:12; journal:GUT; https://hdl.handle.net/2434/1249239 – Name: DOI Label: DOI Group: ID Data: 10.1136/gutjnl-2023-330721 – Name: URL Label: Availability Group: URL Data: https://hdl.handle.net/2434/1249239<br />https://doi.org/10.1136/gutjnl-2023-330721 – Name: Copyright Label: Rights Group: Cpyrght Data: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ – Name: AN Label: Accession Number Group: ID Data: edsbas.9F3F2C6F |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edsbas&AN=edsbas.9F3F2C6F |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1136/gutjnl-2023-330721 Languages: – Text: English Subjects: – SubjectFull: Barrett's metaplasia Type: general – SubjectFull: Barrett's oesophagu Type: general – SubjectFull: gastric metaplasia Type: general – SubjectFull: oesophageal cancer Type: general – SubjectFull: surveillance Type: general – SubjectFull: Settore BIOS-08/A - Biologia molecolare Type: general Titles: – TitleFull: Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett's oesophagus surveillance: Individual-level data analysis Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Black E. L. – PersonEntity: Name: NameFull: Ococks E. – PersonEntity: Name: NameFull: Devonshire G. – PersonEntity: Name: NameFull: Ng A. W. T. – PersonEntity: Name: NameFull: O'Donovan M. – PersonEntity: Name: NameFull: Malhotra S. – PersonEntity: Name: NameFull: Tripathi M. – PersonEntity: Name: NameFull: Ciccarelli FD – PersonEntity: Name: NameFull: Miremadi A. – PersonEntity: Name: NameFull: Freeman A. – PersonEntity: Name: NameFull: Coles H. – PersonEntity: Name: NameFull: Fitzgerald R. C. – PersonEntity: Name: NameFull: E.L. Black – PersonEntity: Name: NameFull: E. Ocock – PersonEntity: Name: NameFull: G. Devonshire – PersonEntity: Name: NameFull: A.W.T. Ng – PersonEntity: Name: NameFull: M. O'Donovan – PersonEntity: Name: NameFull: S. Malhotra – PersonEntity: Name: NameFull: M. Tripathi – PersonEntity: Name: NameFull: F. Ciccarelli – PersonEntity: Name: NameFull: A. Miremadi – PersonEntity: Name: NameFull: A. Freeman – PersonEntity: Name: NameFull: H. Cole – PersonEntity: Name: NameFull: R.C. Fitzgerald IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Type: published Y: 2024 Identifiers: – Type: issn-locals Value: edsbas – Type: issn-locals Value: edsbas.oa |
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