Biomarkers in premalignant conditions of the gastrointestinal tract: Studies on Barrett’s esophagus and primary sclerosing cholangitis

In this thesis we have described our research on genetic abnormalities in (pre)malignant conditions of the gastrointestinal tract. The wide variation in biological behavior of cancerous and precancerous conditions may be largely explained by differences in genetic abnormalities. They are a source of useful information that will increase our understanding of the mechanisms that drive cancer progression and therefore will help to improve cancer prevention and treatment strategies. We studied two chronic inflammatory conditions that are both associated with an increased risk of cancer: Barrett’s esophagus and primary sclerosing cholangitis. Barrett’s esophagus is recognized as a precursor lesion for esophageal adenocarcinoma and primary sclerosing cholangitis is a strong risk factor for cholangiocarcinoma. Both cancers are highly aggressive diseases with extreme poor outcomes. We investigated genetic abnormalities and their potential as biomarkers in different aspects of cancer management including prediction of future progression, prediction of response to therapy and early detection of cancer.