Independent validation of a tissue systems pathology assay to predict future progression in nondysplastic barrett's esophagus
| Autor: | Emily A. Bossart, Roos E. Pouw, Katelyn Stebbins, Kadere Konte, Yi Zhang, Nicola Frei, Jacques J. Bergman, Rebecca J. Critchley-Thorne |
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| Přispěvatelé: | Gastroenterology and hepatology, CCA - Cancer Treatment and quality of life, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer biology and immunology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms Biopsy Population Adenocarcinoma Risk Assessment Gastroenterology Article Barrett Esophagus 03 medical and health sciences Esophagus Spatio-Temporal Analysis 0302 clinical medicine Predictive Value of Tests Internal medicine Prevalence medicine Humans education Aged Netherlands education.field_of_study medicine.diagnostic_test business.industry Case-control study Middle Aged medicine.disease medicine.anatomical_structure Dysplasia Case-Control Studies 030220 oncology & carcinogenesis Barrett's esophagus Predictive value of tests Cohort Disease Progression Female 030211 gastroenterology & hepatology Esophagoscopy business Follow-Up Studies |
| Zdroj: | CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, 11(10):e00244. Nature Publishing Group Clinical and Translational Gastroenterology Frei, N F, Konte, K, Bossart, E A, Stebbins, K, Zhang, Y, Pouw, R E, Critchley-Thorne, R J & Bergman, J J G H M 2020, ' Independent validation of a tissue systems pathology assay to predict future progression in nondysplastic barrett's esophagus : A spatial-temporal analysis ', CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, vol. 11, no. 10, e00244 . https://doi.org/10.14309/ctg.0000000000000244 Clinical and translational gastroenterology, 11(10):e00244. Nature Publishing Group |
| ISSN: | 2155-384X |
| DOI: | 10.14309/ctg.0000000000000244 |
| Popis: | INTRODUCTION: An automated risk prediction assay has previously been shown to objectively identify patients with nondysplastic Barrett's esophagus (NDBE) who are at increased risk of malignant progression. To evaluate the predictive performance of the assay in 76 patients with NDBE of which 38 progressed to high-grade dysplasia/esophageal adenocarcinoma (progressors) and 38 did not (nonprogressors) and to determine whether assessment of additional (spatial) levels per endoscopy and/or multiple (temporal) time points improves assay performance. METHODS: In a blinded, nested case-control cohort, progressors and nonprogressors were matched (age, sex, and Barrett's esophagus length). All random biopsy levels from the baseline endoscopy (spatial samples) and all available previous endoscopies back to 10 years before progression (temporal samples) were assayed. Because the 1:1 ratio of progressors to nonprogressors does not reflect the real-world Barrett's population, negative and positive predictive values were adjusted for prevalence. RESULTS: Seventy-six patients (58 men), mean age of 63 6 9 years, were studied. A high-risk score was associated with a prevalence-adjusted annual progression rate of 6.9%. The assay identified 31% of progressors when assessing a single biopsy level from the baseline endoscopy. Sensitivity increased to 50% and 69% in spatial and temporal analyses, respectively, while specificity remained at 95%. DISCUSSION: The assay identified a significant subset of NDBE patients who progress at a rate comparable with published estimates for expert-confirmed low-grade dysplasia. Assessing additional spatial and temporal biopsies increased the predictive accuracy, allowing for identification of most future progressors. Additional studies will evaluate the predictive performance of the assay in low-prevalence settings. |
| Databáze: | OpenAIRE |
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