{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:43:34Z","timestamp":1792795414704,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014461","name":"NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust\/Institute of Cancer Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014461","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Barrett's oesophagus with indefinite for dysplasia (BE\u2010IND) is a subjective diagnosis with a low interobserver agreement (IOA) among pathologists and uncertain clinical implications. This study aimed to assess the utility of p53 immunohistochemistry (p53\u2010IHC) in assessing BE\u2010IND specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Archive endoscopic biopsies with a BE\u2010IND diagnosis from two academic centres were analysed. First, haematoxylin and eosin\u2010stained slides (H&amp;E) were reviewed by four expert gastrointestinal (GI) pathologists allocated into two groups (A and B). After a washout period of at least 8\u2009weeks, H&amp;E slides were reassessed side\u2010to\u2010side with p53\u2010IHC available. We compared the rate of changed diagnosis and the IOA for all BE grades before and after p53\u2010IHC. We included 216 BE\u2010IND specimens from 185 patients, 44.0 and 32.9% of which were confirmed after H&amp;E slide revision by groups A and B, respectively. More than half the cases were reclassified to a non\u2010dysplastic BE (NDBE), while 5.6% of cases in group A and 7.4% in group B were reclassified to definite dysplasia. The IOA for NDBE, BE\u2010IND, low\u2010grade dysplasia (LGD) and high\u2010grade dysplasia (HGD)\/intramucosal cancer (IMC) was 0.31, 0.21, \u22120.03 and \u22120.02, respectively. Use of p53\u2010IHC led to a &gt;40% reduction in BE\u2010IND diagnoses (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and increased IOA for all BE grades [\u03ba\u2009=\u20090.46 (NDBE), 0.26 (BE\u2010IND), 0.49 (LGD), 0.35 (HGD\/IMC)]. An aberrant p53\u2010IHC pattern significantly increased the likelihood of reclassifying BE\u2010IND to definite dysplasia (odds ratio\u2009=\u200944.3, 95% confidence interval\u2009=\u200918.8\u2013113.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>P53\u2010IHC reduces the rate of BE\u2010IND diagnoses and improves the IOA among pathologists when reporting BE with equivocal epithelial changes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14642","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T11:20:00Z","timestamp":1646997600000},"page":"1081-1090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["The utility of <scp>P53<\/scp> immunohistochemistry in the diagnosis of Barrett's oesophagus with indefinite for dysplasia"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8200-2661","authenticated-orcid":false,"given":"Wladyslaw","family":"Januszewicz","sequence":"first","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"},{"name":"Department of Gastroenterology Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nastazja D","family":"Pilonis","sequence":"additional","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Sawas","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8978-9743","authenticated-orcid":false,"given":"Richard","family":"Phillips","sequence":"additional","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"O'Donovan","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Miremadi","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienn","family":"Blasko","sequence":"additional","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Katzka","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca C","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"di Pietro","sequence":"additional","affiliation":[{"name":"Early 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