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Molecular changes in the progression of Barrett’s oesophagus

¹ Department of Gastroenterology, Institute of Oncology, Warsaw, Poland
² Department of Clinical Pharmacology, University of Oxford, Oxford, UK

Correspondence to:
Correspondence to:
Professor Janusz Jankowski
Department of Clinical Pharmacology, Radcliffe Infirmary, University of Oxford OX2 6HE, UK; janusz.jankowski{at}clinpharm.ox.ac.uk

Barrett’s oesophagus is a frequent complication of gastro-oesophageal reflux disease predicting oesophageal adenocarcinoma. The majority of Barrett’s patients will not develop cancer, so that specific methods of identification of those at risk are required. Recent molecular studies have identified a selection of candidate biomarkers that need validation in prospective studies. They reflect various changes in cell behaviour during neoplastic progression. The ASPECT trial in the UK aims to establish whether chemoprevention with aspirin and a proton pump inhibitor will reduce adenocarcinoma development and mortality in patients with Barrett’s oesophagus. It will also validate biomarkers for progression and clinical response and further study disease pathogenesis.

Abbreviations: APC, adenomatous polyposis coli; COX-2, cyclooxygenase-2; ECGF1, endothelial growth factor 1; GORD, gastro-oesophageal reflux disease; HGD, high grade dysplasia; hTERT, telomerase reverse transcriptase catalytic sub-unit; hTR, telomerase RNA; LGD, low grade dysplasia; LOH, loss of heterozygosity; NSAIDs, non-steroidal anti-inflammatory drugs; PPI, proton pump inhibitor; PCNA, proliferating cell nuclear antigen; PGE2, prostaglandin E2; SFRP, secreted frizzled-related proteins; SPARC, secreted protein, acidic, cysteine-rich; TRAP, telomerase repeat assay protocol; TSPAN, tetraspan1