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Complex Diseases in Gastroenterology and Hepatology: GERD, Barrett’s, and Esophageal Adenocarcinoma
Rebecca C. Fitzgerald Clinical Gastroenterology and Hepatology Volume 3, Issue 6, Pages (June 2005) DOI: /S (05)00248-X Copyright © 2005 American Gastroenterological Association Terms and Conditions
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Figure 1 Pedigree with familial Barrett’s esophagus/esophageal adenocarcinoma. Proband with Barrett’s esophagus whose siblings have not been endoscoped. Her mother also had Barrett’s esophagus but the family history on her father’s side is striking with 3 of 5 siblings with proven Barrett’s esophagus or adenocarcinoma and the fourth sibling had an esophageal stricture. The paternal grandfather died of esophageal cancer. hb, heartburn; hh, hiatus hernia. Clinical Gastroenterology and Hepatology 2005 3, DOI: ( /S (05)00248-X) Copyright © 2005 American Gastroenterological Association Terms and Conditions
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Figure 2 Simplified overview of molecular alterations occurring during the metaplasia–dysplasia–carcinoma sequence in esophagus. Representative histopathologic appearances for each stage are shown in the top panel. Typical molecular changes for each stage are given in the lower shaded bars. The categories of changes are grouped together according to whether the principle effect is on proliferation, apoptosis, or invasion and metastasis. These are simplified groupings because alterations can have multiple effects, for example, cyclooxygenase-2 on invasion, metastasis, and proliferation. In addition, the changes tend to occur either early, such as loss of p16, or late, such as alterations in p53, but this sequence is not obligatory. Clinical Gastroenterology and Hepatology 2005 3, DOI: ( /S (05)00248-X) Copyright © 2005 American Gastroenterological Association Terms and Conditions
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Figure 3 Example of flow cytometry data obtained from endoscopic samples of esophagus. The areas marked 2N and 4N denote cells in the G1 and G2/M (or mitosis) phases, respectively, and the cross-hatched area is the S (or DNA replication) phase fraction. (A) Representative normal profile taken from a patient with nondysplastic Barrett’s esophagus. (B) Abnormal profile from an esophageal adenocarcinoma sample that shows an aneuploid fraction of cells (abnormal shoulder to the profile denoted by an arrow), an increased proportion of cells in G2/M phase, and an aneuploid population is shown at 6N. Clinical Gastroenterology and Hepatology 2005 3, DOI: ( /S (05)00248-X) Copyright © 2005 American Gastroenterological Association Terms and Conditions
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