A novel test developed by Johns Hopkins Kimmel Cancer Center investigators could give gastroenterologists insight into which patients with Barrett's esophagus—a premalignant condition in which parts of the esophagus become damaged by chronic acid reflux—are likely to progress to esophageal cancer or an abnormal collection of cells called high-grade dysplasia. This information could help physicians determine how to monitor or manage patients during clinical care. The test, called Esopredict, is a PCR ( )-based laboratory test that, from biopsy samples, measures the level of DNA methylation changes in the genes RUNX3, p16, HPP1 and FBN1.
Methylation changes often occur early during abnormal cell growth, before conditions can be detected clinically. By combining these results with patients' age, physicians can gauge the likelihood that patients' premalignant conditions will advance, and help them determine how often to monitor or manage patients with potential neoplastic progression. Using the tool in previously collected biopsies from 240 patients with Barrett's esophagus from six medical centers, researchers determined that the overall risk for neoplastic progression was 5.
1%. Patients in the highest risk group had a 21.7% risk of developing high-grade dysplasia or , compared with a 6.
87% risk among those in the high moderate group, a 3.25% risk for those in the low moderate group and just 1.27% among those in the lowest risk group.
A description of the work was in the . T.