Evolution of esosphageal adenocarcinoma and implications for screening and surveillance

This nice review updates the molecular/genomic changes leading to esophageal adenocarcinoma and makes the link to more effective screening and treatment approaches.

Tom Vaughan

03 May 2022 — 1 min read

Nat Rev Cancer. 2021 Nov;21(11):731-741. doi: 10.1038/s41568-021-00400-x. Epub 2021 Sep 20.

Evolution and progression of Barrett's oesophagus to oesophageal cancer

Sarah Killcoyne 1 2, Rebecca C Fitzgerald 3

PMID: 34545238 DOI: 10.1038/s41568-021-00400-x

Abstract

Cancer cells are shaped through an evolutionary process of DNA mutation, cell selection and population expansion. Early steps in this process are driven by a set of mutated driver genes and structural alterations to the genome through copy number gains or losses. Oesophageal adenocarcinoma (EAC) and the pre-invasive tissue, Barrett's oesophagus (BE), provide an ideal example in which to observe and study this evolution. BE displays early genomic instability, specifically in copy number changes that may later be observed in EAC. Furthermore, these early changes result in patterns of progression (that is, 'born bad', gradual or catastrophic) that may help to describe the evolution of EAC. As only a small proportion of patients with BE will go on to develop cancer, a better understanding of these patterns and the resulting genomic changes should improve early detection in EAC and may provide clues for the evolution of cancer more broadly.

Liquid biopsy to diagnose esophageal adenocarcinoma

This impressive multicenter study by Miyoshi et al. introduces a new diagnostic tool named EMERALD, which is a six-circulating miRNA signature designed to effectively differentiate patients with esophageal adenocarcinoma (EAC) and its precursor, Barrett's esophagus (BE), from non-disease controls. The research involved analyzing 792 patient samples across four

Neoplastic progression in young Barrett's patients

Esophageal adenocarcinoma is quite rare among persons younger than 40 years, but the consequences of the disease, including years of life lost, can be devastating. Due to its rarity there has been little research on how risk factors in young persons (e.g., Barrett's esophagus (BE), obesity, GERD,

Diagnosis and management of GERD

While most adults occasionally experience symptoms of gastroesophageal reflux, such as heartburn and regurgitation, approximately 20% (30 million people in the U.S.) experience these symptoms more frequently, ranging from once a week to multiple times a day. (1) Complications associated with GERD can include esophageal strictures, ulcers, and even

Ethics of screening based on race/ethnicity

This article explores some of the ethical implications of using race and ethnicity for cancer screening, using esophageal adenocarcinoma and gastric cancer as examples. It highlights the disparities in cancer incidence and mortality among different racial and ethnic groups and examines the potential benefits and drawbacks of screening based (in