A personalized and dynamic risk estimation model: The new paradigm in Barrett's esophagus surveillance

The current surveillance strategy in Barrett's esophagus (BE) uses only histological findings of the last endoscopy to assess neoplastic progression risk. As predictor values vary across endoscopies, single measurements may not be an accurate reflection. Our aim was to explore the value of usin...

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Bibliographic Details
Published in:PloS one 2022-04, Vol.17 (4), p.e0267503
Main Authors: Roumans, Carlijn A M, Spaander, Manon C W, Lansdorp-Vogelaar, Iris, Biermann, Katharina, Bruno, Marco J, Steyerberg, Ewout W, Rizopoulos, Dimitris
Format: Article
Language:English
Subjects:
Adenocarcinoma
Barrett Esophagus - pathology
Barrett's esophagus
Biology and Life Sciences
Biomarkers
Biopsy
Customization
Diagnosis
Dysplasia
Endoscopy
Esophageal cancer
Esophageal Neoplasms - pathology
Esophagus
Evolution
Gastroenterology
Gender
Health surveillance
Hepatology
Humans
Hyperplasia
Intervals
Medicine and Health Sciences
Modelling
Mortality
Patients
Public health
Risk factors
Tumor Suppressor Protein p53
Values
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Summary:The current surveillance strategy in Barrett's esophagus (BE) uses only histological findings of the last endoscopy to assess neoplastic progression risk. As predictor values vary across endoscopies, single measurements may not be an accurate reflection. Our aim was to explore the value of using longitudinal evolutions (i.e. successive measurements) of histological findings (low-grade dysplasia (LGD)) and immunohistochemical biomarkers (p53 and SOX2) by investigating the association with Barrett's progression. In this proof-of-principle study of a longitudinal dynamic risk estimation model with a multicenter cohort design, 631 BE patients from 15 Dutch hospitals who were under surveillance were included. Longitudinal dynamic values of LGD, p53, and SOX2 were included in a multivariate joint model to estimate the risk of high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC). Longitudinal evolutions of aberrant expression of p53 (HR 1.26, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0267503