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J Mol Diagn. 2015 Jul;17(4):412-9. doi: 10.1016/j.jmoldx.2015.02.006. Epub 2015 Jun 8.

Evaluation of Mutational Testing of Preneoplastic Barrett's Mucosa by Next-Generation Sequencing of Formalin-Fixed, Paraffin-Embedded Endoscopic Samples for Detection of Concurrent Dysplasia and Adenocarcinoma in Barrett's Esophagus.

Author information

1
Department of Pathology and Cell Biology, Columbia University, New York City, New York.
2
Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
3
Department of Pathology, Shinshu University, Nagano, Japan.
4
Department of Genetics, University of Pennsylvania, Philadelphia, Pennsylvania.
5
Division of Gastroenterology, Columbia University, New York City, New York.
6
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
7
Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania.
8
Department of Pathology and Cell Biology, Columbia University, New York City, New York. Electronic address: as4400@columbia.edu.

Abstract

Barrett's intestinal metaplasia (BIM) may harbor genomic mutations before the histologic appearance of dysplasia and cancer and requires frequent surveillance. We explored next-generation sequencing to detect mutations with the analytical sensitivity required to predict concurrent high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus by testing nonneoplastic BIM. Formalin-fixed, paraffin-embedded (FFPE) routine biopsy or endoscopic mucosal resection samples from 32 patients were tested: nonprogressors to HGD or EAC (BIM-NP) with BIM, who never had a diagnosis of dysplasia or EAC (N = 13); progressors to HGD or EAC (BIM-P) with BIM and a worse diagnosis of HGD or EAC (N = 15); and four BIM-negative samples. No mutations were detected in the BIM-NP (0 of 13) or BIM-negative samples, whereas the BIM-P samples had mutations in 6 (75%) of 8 cases in TP53, APC, and CDKN2A (P = 0.0005), detected in samples with as low as 20% BIM. We found that next-generation sequencing from routine FFPE nonneoplastic Barrett's esophagus samples can detect multiple mutations in minute areas of BIM with high analytical sensitivity. Next-generation sequencing panels for detection of TP53 and possibly combined mutations in other genes, such as APC and CDKN2A, may be useful in the clinical setting to improve dysplasia and cancer surveillance in patients with Barrett's esophagus.

PMID:
26068095
PMCID:
PMC4484205
DOI:
10.1016/j.jmoldx.2015.02.006
[Indexed for MEDLINE]
Free PMC Article

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