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Title: Barrett's dysplasia-adenocarcinoma : role of the leukotriene pathway and treatment with radiofrequency ablation
Author: Boger, Philip
Awarding Body: University of Southampton
Current Institution: University of Southampton
Date of Award: 2012
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Upregulation of the 5-lipoxygenase (5-LOX) pathway is linked to promotion of cancer cell growth, but its role and cellular sources in Barrett's metaplasia (BM) and oesophageal adenocarcinoma (OA) are not fully understood. Radiofrequency ablation (RFA) is an alternative new technology for treating high grade dysplasia (HGD) in BM to prevent cancer. Whether it represents a cost-effective alternative to oesophagectomy is unknown. Methods Immunohistochemistry was performed on stromal and epithelial areas of BM and OA tissue, with proximal squamous tissue as control. Epitheli al and stromal areas of tissue sUbtypes were isolated using laser capture microdissection, mRNA extracted, reverse transcribed and RT-qPCR assays performed for the 5-LOX pathway genes. A cost-utility analysis was undertaken using a Markov model to simulate the natural history of a cohort of patients with HGD in BM undergoing one of two treatment options: (i) oesophagectomy or (ii) RFA followed by endoscopic surveillance with oesophagectomy for HGD recurrence or persistence. Results Significant increases in stromal immunoexpression of 5-LOX pathway enzymes were seen in OA tissue, with correlation of FLAP and LTA4H immunostaining with elevated neutrophil counts (p
Supervisor: Patel, Praful ; Sampson, Anthony Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available