Barrett's esophagus and esophageal adenocarcinoma: transcription factors and biomarkers

Esophageal adenocarcinoma is a deadly cancer of the esophagus. Barrett’s esophagus is a precursor lesion of esophageal adenocarcinoma. Currently, the development of Barrett’s esophagus and esophageal adenocarcinoma is poorly understood. In this thesis, we show that signaling pathways and transcription factors that are involved in the embryological development of the esophagus also play a central role in the development of Barrett’s esophagus and oesophageal adenocarcinoma. Barrett’s esophagus is treatable, while oesophageal adenocarcinoma is often diagnosed too late. In a pilot study we show that miRNA’s, a group of small nucleotide molecules that are remarkably stable in patiënt’s blood, can be usefull to identify patients with Barrett’s esophagus. Currently, curative treatment for oesophageal adenocarcinoma consists of chemo-and radiotherapy followed by surgery. Some patients with esophageal adenocarcinoma do well after treatment, while others respond poorly. We show that patients whose tumors do not express the proteins CD44 and SOX2 have a better survival compared with patients whose cancer does express these two proteins.