Multifaceted Examination of Endoscopic Biopsy Tissues Aimed at Stratifying the Risk of Barrett's Esophagus-associated Carcinogenesis

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K07956
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Chiba University
• Principal Investigator: Tokunaga Mamoru 千葉大学, 大学院医学研究院, 特任助教 (30866992)
• Co-Investigator(Kenkyū-buntansha): 松村 倫明 千葉大学, 医学部附属病院, 講師 (00514530) ; 沖元 謙一郎 千葉大学, 医学部附属病院, 助教 (30770739)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 食道バレット腺癌

Outline of Final Research Achievements

We investigated somatic mutations in 24 cases of Barrett's esophagus (BE) without coexisting esophageal adenocarcinoma (EAC) and 9 cases of EAC (11 lesions: 3 lesions treated with endoscopic mucosal resection (EMRC) and 8 lesions treated with endoscopic submucosal dissection (ESD)), totaling 33 cases. The number of putative driver mutations per sample (median, range) was 0 (0-1) for short-segment BE (SSBE), 0 (0-1) for long-segment BE (LSBE), 1 (0-3) for EAC, and 1 (0-2) for surrounding BE. Notably, surrounding BE harbored a higher number of putative driver mutations compared to BE (p < 0.01), although no significant difference was observed between surrounding BE and EAC (p = 1.00). Putative driver mutations in TP53 were identified in 2 cases of SSBE without coexisting EAC (16.7%).

Free Research Field

消化器内科

Academic Significance and Societal Importance of the Research Achievements

従来発癌性の低いと思われてたSSBEにもTP53の変異が認められる事が判明した。内視鏡的にもSSBEのフォローの重要性が確認され、今後、検診の場において重要な要素となると考えられる。また本邦で増加傾向にある食道バレット腺癌は遺伝子背景が欧米の報告と近い事が判明した今後現状よりさらに症例が増えていくのか等、注視されるべき分野である。