Karyometry in Barrett's esophagus

OBJECTIVE: To derive a progression curve for lesions in Barrett's esophagus based on karyometric features. STUDY DESIGN: High-resolution imagery of 900 nuclei from normal gastric tis sue, Barrett's metaplasia, Barrett's high grade dysplasia and adenocarcinom a of the esophagus was recorded. Karyometric features were computed, and nu clear signatures and lesion signatures for these lesions were derived. A pr ogression curve was defined. RESULTS: Esophageal lesions were distinctly different from the normal gastr ic fundus tissue, with nuclei from Barrett's metaplasia deviating from norm al almost as much as nuclei from high grade dysplasia and adenocarcinoma. T here was considerable case-to-case variability and overlap between lesions histologically assigned to different diagnostic categories. CONCLUSION: The karyometric data suggest that Barrett's metaplasia is a mor e developed lesion than previously assumed.