Aberrant p53 expression, a stronger risk factor for neoplastic progression in Barrett's esophagus than…

Cohort studyEndoscopy· Jun 2026

Aberrant p53 expression, a stronger risk factor for neoplastic progression in Barrett's esophagus than confirmed low grade dysplasia: a large multicenter prospective cohort study.

Pauline A Zellenrath, Nanda Provoost, Jeliena C M Jansen … Probar Study Group

Gastrointestinal & Liver PathologyCohort studyPrognosisQ2IF 1.2

Aberrant p53 expression, not repeated low grade dysplasia, predicts progression in Barrett's esophagus.

Aberrant p53 expression, a stronger risk factor for neoplastic progression in Barrett's esophagus than confirmed low grade dysplasia: a large multicenter prospective cohort study.

Pauline A Zellenrath … Probar Study Group

Endoscopy · Jun 2026

Background

Low grade dysplasia (low grade dysplasia) diagnosed on multiple occasions is considered the strongest risk factor for neoplastic progression in patients with Barrett's esophagus (BE); however, recent studies have shown that aberrant p53 expression may be a more powerful risk factor for progression.

Purpose

This study aimed to compare the association between aberrant p53 expression versus low grade dysplasia diagnosed on two or more occasions and neoplastic progression risk.

Methods

With a BE segment length ≥ 2 cm were included in a multicenter prospective cohort. p53 expression was determined by immunohistochemistry staining.

n = 960 patients

Results

aberrant p53 raised progression risk about twentyfold versus normal p53

HR 0.84 (95% CI 0.47 to 1.53)

null 1

0.47

1.53

CI crosses the null - not significant

More results

In contrast, low grade dysplasia on multiple occasions was not similarly associated (HR 0.84, 95 %CI 0.47-1.53), after adjustment for age, sex, and segment length.

Progression-free survival was better in patients with normal versus aberrant p53 expression, regardless of the histopathological diagnosis ( P < 0.001).

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Conclusion · 1 of 2

Aberrant p53 expression is strongly associated with an increased neoplastic progression risk in BE patients, regardless of the histopathological findings.

Conclusion · 2 of 2

It may therefore be a better parameter than confirmed low grade dysplasia on multiple occasions to identify patients who might benefit from ablation therapy.

Aberrant p53 expression, a stronger risk factor for neoplastic progression in Barrett's esophagus than confirmed low grade dysplasia: a large multicenter prospective cohort study.

Aberrant p53 expression, a stronger risk factor for neoplastic progression in Barrett's esophagus than confirmed low grade dysplasia: a large multicenter prospective cohort study.

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