Y Chromosome Loss is a Frequent Event in Barrett's Adenocarcinoma and Associated with Poor Outcome.

Background: The loss of the Y chromosome in various malignant diseases has been described previously. There are no reliable information on the actual frequency, significance and homogeneity of Y chromosome loss () in esophageal adenocarcinoma (EAC).

Methods: 400 male EAC including lymph-node metastases were analyzed with commercially available Y chromosome specific fluorescence in-situ probes. The results were correlated with molecular and immunohistochemical markers and clinicopathological aspects.

Results: The entire cohort ( = 400) showed a singular of one chromosome arm in 1.0% (q-arm) and 2.8% (p-arm), complete in 52.5%. was strongly associated with shortened overall-survival (OS). Patients with preserved Y chromosome had a median OS of 58.8 months, patients with an OS of 19.4 months ( < 0.001). Multivariate analysis showed as an independent prognostic marker with a hazard ratio of 1.835 (95% CI 1.233-2.725). correlated with mutations ( = 0.003), amplification ( = 0.004), loss of ARID1a ( = 0.045) and presence of LAG3 ( = 0.018).

Conclusions: Loss of the Y chromosome is a very common phenomenon in EAC. The is heterogeneously distributed within the tumor, but corresponding lymph node metastases frequently show homogeneous indicating a selection and metastasizing advantage with poor prognosis. To date, the male predominance of EAC (7-9:1) is unclear, so genetic explanatory models are favored. The in EAC may be biologically and functionally relevant and additional genomic or functional analyses are needed.