Degree of crypt atypia correlates with progression to high‐grade dysplasia/adenocarcinoma in non‐dysplastic Barrett's oesophagus

Author:

Odze Robert1,Frei Nicola2,Khoshiwal Amir M2,Duits Lucas C2,Bergman Jacques2,Stachler Matthew D3ORCID

Affiliation:

1. Tufts University School of Medicine Boston MA USA

2. Amsterdam UMC Locatie AMC Amsterdam the Netherlands

3. Department of Pathology University of California San Francisco San Francisco CA USA

Abstract

AimsPatients with non‐dysplastic Barrett's oesophagus (BE) often show a wide range of ‘atypical’ histological features in the bases of the crypts. However, the significance of crypt atypia has never been evaluated, despite prior studies showing the presence of DNA content and other molecular abnormalities in this epithelium. The aim of this study was to evaluate whether the degree of crypt atypia in BE patients without dysplasia correlates with progression to high‐grade dysplasia/adenocarcinoma (HGD/EAC).Methods and resultsBaseline biopsies from 114 BE patients without dysplasia, 57 who progressed to HGD/EAC (progressors) and 57 who did not progress (non‐progressors), were included in the study. Biopsies were evaluated for the degree of basal crypt atypia on a three‐point scale according to discrete histological criteria. In non‐progressors, 64.9, 31.6 and 3.5% of biopsies had a crypt atypia score of 1, 2 and 3, respectively, with a mean score of 1.39 ± 0.56. The percentage of biopsies with an atypia score of 2 or 3 increased in progressors [42.1, 42.1 and 15.8% of biopsies scored 1, 2 or 3, respectively, with a mean score of 1.74 ± 0.72 (P = 0.004)]. The odds ratio of grade 3 crypt atypia for progression to HGD/EAC was 5.2 (95% confidence interval = 1.1–25.0, P = 0.04) and the findings did not change significantly when the data were analysed according to progression to either HGD or EAC.ConclusionsThis study shows that non‐dysplastic crypts in BE are biologically abnormal, suggesting that neoplastic progression begins prior to the onset of dysplasia. The degree of crypt atypia in BE patients without dysplasia correlates with progression.

Funder

Doris Duke Charitable Foundation

National Institute of Diabetes and Digestive and Kidney Diseases

Publisher

Wiley

Subject

General Medicine,Histology,Pathology and Forensic Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. “Syphilitic Hepatitis”;Journal of Clinical Gastroenterology;2024-06-20

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