A Tissue Systems Pathology Assay for High-Risk Barrett's Esophagus
| Autor: | Gregory G. Ginsberg, Blair A. Jobe, Nirag Jhala, Kathleen A. Repa, Maureen DeMarshall, Tyler Foxwell, Jeffrey W. Prichard, Yi Zhang, Gary W. Falk, David L. Diehl, D. Lansing Taylor, Lucas C. Duits, Jon M. Davison, Rebecca J. Critchley-Thorne, Anil K. Rustgi, Lia M Reese, Ali H. Zaidi, Bruce B. Campbell, Jacques J. Bergman, Jinhong Li |
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| Přispěvatelé: | Graduate School, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Gastroenterology and Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Esophageal Neoplasms Epidemiology Biopsy Fluorescent Antibody Technique Adenocarcinoma Gastroenterology Article Barrett Esophagus 03 medical and health sciences Esophagus 0302 clinical medicine Internal medicine Biomarkers Tumor medicine Humans False Positive Reactions Aged Training set medicine.diagnostic_test business.industry Case-control study Middle Aged Prognosis medicine.disease Confidence interval digestive system diseases medicine.anatomical_structure Microscopy Fluorescence Oncology Dysplasia Case-Control Studies 030220 oncology & carcinogenesis Barrett's esophagus Disease Progression Biomarker (medicine) Female 030211 gastroenterology & hepatology business |
| Zdroj: | Cancer epidemiology, biomarkers & prevention, 25(6), 958-968. American Association for Cancer Research Inc. |
| ISSN: | 1055-9965 |
| Popis: | Background: Better methods are needed to predict risk of progression for Barrett's esophagus. We aimed to determine whether a tissue systems pathology approach could predict progression in patients with nondysplastic Barrett's esophagus, indefinite for dysplasia, or low-grade dysplasia. Methods: We performed a nested case–control study to develop and validate a test that predicts progression of Barrett's esophagus to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC), based upon quantification of epithelial and stromal variables in baseline biopsies. Data were collected from Barrett's esophagus patients at four institutions. Patients who progressed to HGD or EAC in ≥1 year (n = 79) were matched with patients who did not progress (n = 287). Biopsies were assigned randomly to training or validation sets. Immunofluorescence analyses were performed for 14 biomarkers and quantitative biomarker and morphometric features were analyzed. Prognostic features were selected in the training set and combined into classifiers. The top-performing classifier was assessed in the validation set. Results: A 3-tier, 15-feature classifier was selected in the training set and tested in the validation set. The classifier stratified patients into low-, intermediate-, and high-risk classes [HR, 9.42; 95% confidence interval, 4.6–19.24 (high-risk vs. low-risk); P < 0.0001]. It also provided independent prognostic information that outperformed predictions based on pathology analysis, segment length, age, sex, or p53 overexpression. Conclusion: We developed a tissue systems pathology test that better predicts risk of progression in Barrett's esophagus than clinicopathologic variables. Impact: The test has the potential to improve upon histologic analysis as an objective method to risk stratify Barrett's esophagus patients. Cancer Epidemiol Biomarkers Prev; 25(6); 958–68. ©2016 AACR. |
| Databáze: | OpenAIRE |
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