The genetic diversity measured between the cells affected by Barrett’s oesophagus has been found to be a good predictor of which patients are at a high risk of developing oesophageal cancer.
This finding could offer greater quality of life to patients with Barrett’s oesophagus and save costs for healthcare providers. While most people with the condition are at a low-risk of developing oesophageal cancer, a minority still remains at high-risk of death if cancer develops. Previously, there has been no easy way to determine the likelihood of a Barrett’s patient developing cancer, requiring them to have regular monitoring via repeated endoscopic procedures.
New research shows that the burden of low-risk patients receiving repeated endoscopies could be avoided by instead measuring which patients have genetically diverse cell populations in the lesions caused by Barrett’s oesophagus. The results of the study showed that patients with a more diverse collection of the abnormal affected cells had a higher risk of developing oesophageal cancer.
Dr Trevor Graham, Bart’s Cancer Institute, Queen Mary University of London, London, UK, explained: “Once these results are validated in other patients and over longer periods of time, we will be able to say with confidence which people with the benign form can be spared unnecessary endoscopy and worry. This will dramatically improve the quality of life for people with Barrett’s, and provide substantial cost saving to healthcare providers.”
Dr Graham and colleagues followed 320 Barrett’s patients for a median period of 43 months, analysing around 50,000 cells to measure and track over time the genetic diversity in oesophageal lesions. The team found that a higher diversity of cells was a good predictor of a high cancer risk which could be due to the increased likelihood of ‘bad’ cells progressing into cancer.
Additionally, the team found that the genetic diversity of the affected cells was fixed over time and mutations had little impact on the development of the lesions. This means that the future risk of developing cancer could be predicted regardless of when abnormal Barrett’s cells first appeared. Dr Graham states: “Our findings are important because they imply that a person’s risk of developing oesophageal cancer is fixed over time. In other words, we can predict from the outset which Barrett’s patients fall into a high risk group of developing cancer and that risk does not change thereafter.”