Explore a comprehensive lecture on mapping pre-cancer to predict future outcomes, focusing on lessons from oesophageal cancer. Delve into the increasing incidence and poor outcomes of oesophageal adenocarcinoma, early detection methods, and the link between mutational processes in ageing and cancer. Examine molecular drivers of Barrett's oesophagus progression, treatments for oesophageal cancer, and curative therapies for dysplasia and early-stage disease. Investigate the gastric origin of Barrett's oesophagus and its malignant transition, as well as risk factors and screening methods for oesophageal adenocarcinoma. Learn about innovative diagnostic tools such as the Cytosponge-TFF3 test, pan-cancer cell-free DNA tests, and breath biopsy. Analyze clinical trial results, surveillance protocols, and biomarkers for dysplasia detection, including p53 immunohistochemistry and DNA copy number alterations. Gain insights into decision-making processes for Barrett's surveillance and potential improvements in risk stratification using advanced biomarkers.
Mapping Pre-Cancer to Predict Oesophageal Cancer - Stanford Radiology CEDSS 2022
Stanford University via YouTube
Overview
Syllabus
Intro
TODAY'S CEDSS
Introducing oesophageal cancer adenocarcino increasing incidence and poor outcomes
Early detection in oesophageal cancer
Link between mutational processes in ageing and cancer - focus on pre-cancer
Predicting progression in Barrett's: Molecular drivers from benign to malignant
Treatments for oesophageal cancer
Curative therapy for dysplasia and early car
Is Barrett's always the precursor lesion?
Molecular phenotyping suggests gastric origin and malignant transition via Barrett's
Identifying at risk group for oesophagea adenocarcinoma
Risk factors and yield of screening
Device and Assay considerations
Pan-cancer cell free DNA tests
Breath biopsy and volatile analysis
Non-endoscopic device + liquid methylation a
Sample processing for Cytosponge
TFF3 a Barrett's (intestinal metaplasia) biomarker
Manual pathology review aided by TFF3 bion
Machine learning applied to Cytosponge sa
Correlation with TFF3 count and segment le
Clinical trials for Cytosponge screenir
Primary Endpoint Results from BEST3 trial
Clinical evidence base for Cytosponge-TFF3
Monitoring Barrett's patients for dysplasia: Clinical standard surveillance protocol
Relationship p53 and Barrett's dysplasia
Timing of events in Barrett's progression
P53 immunohistochemistry as adjunct to dysplasia diagnosis
Identifying Cytosponge biomarkers for dysp
Decision Tree for Cytosponge Surveilla
Dysplasia yield across risk groups retrospe
Prospective surveillance case-studies
Biomarkers beyond p53 and atypia: DNA copy number and progression status
Can altered DNA copy number (aneuploidy) add V
Potential to add copy number for Barrett's surveillance using Cytosponge
Summary
Funding Acknowledgments
Taught by
Stanford Radiology
