Endoscopic mapping and surrogate markers for better surveillance in Barrett esophagus: A study of 700 biopsy specimens

Parul Bhargava, Glenn M. Eisen, Daniel A. Holterman, Norio Azumi, Dan Paul Hartmann, John J. Hanfelt, Stanley B. Benjamin, Marc E. Lippman, Elizabeth A. Montgomery

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Surveillance methods in Barrett esophagus (BE) using light microscopic examination of random biopsy specimens may miss focal dysplasia. In addition, dysplastic foci identified initially may not be relocated subsequently, making chemoprevention studies difficult. By using a special gastroscope, systematic mapping (4-quadrant biopsy specimens at 1-cm intervals) was performed in 22 patients (33 total mappings yielding 700 biopsy specimens). H & E, immunohistochemistry, and DNA ploidy analysis were performed, c-erbB-2 and positive Ki-67 were detected only in dysplastic sites; thus, their detection did not precede morphologically identifiable dysplasia. On the other hand, aneuploidy and p53 were detected in dysplastic and nondysplastic areas, p53 was correlated with dysplasia, and S-phase narrowly missed correlation, while aneuploidy was not correlated. PCNA and bcl-2 were ubiquitous, limiting their usefulness. On second maps, epithelial type was reidentified with 81% accuracy. A significant correlation was found between p53 and dysplasia. Sites of dysplasia and abnormal biomarkers could be relocated accurately by using endoscopic mapping. Therefore, mapping combined with biomarker studies may provide better surveillance and serve as a useful technique in chemoprevention studies.

Original languageEnglish (US)
Pages (from-to)552-563
Number of pages12
JournalAmerican journal of clinical pathology
Issue number4
StatePublished - Oct 2000
Externally publishedYes


  • Barrett
  • Bcl-2
  • C-erbB-2
  • DNA ploidy
  • Endoscopic mapping
  • Ki-67
  • MIB-1
  • Markers
  • PCNA
  • Prospective
  • p53

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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