Figure 8. Genome doubled EAC shows a distinct pathway of development.
Schematic representation showing two general pathways by which BE can develop into EAC. The top model involves the gradual accumulation of tumor suppressor genes followed by the subsequent activation of oncogenes and development of genomic instability. In the bottom model, TP53 inactivation is acquired as an early event. The sample then undergoes genome doubling, leading to genomic instability, aneuploidy, and oncogene amplification.