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Flow cytometry may be an effective adjunct to standard histology for stratifying cancer risk in patients with Barrett's esophagus (BE) metaplasia. Researchers prospectively evaluated 307 BE patients enrolled in the Seattle Barrett's Esophagus Project to identify flow cytometric variables that predict development of BE-related cancer.
After a mean follow-up of 56 months, 42 patients (13.7%) had developed cancer. High-grade dysplasia, aneuploidy, or elevated 4N fractions were evident at baseline endoscopies in 90% of patients who had developed cancer (38 of 42) and in the 34 patients who progressed to cancer within 5 years. Receiver operating curve analysis demonstrated that 4N fraction cutoffs of 6% to 15% were as predictive of cancer risk (r…