Dataset Information

Missed Opportunities for Screening and Surveillance of Barrett's Esophagus in Veterans with Esophageal Adenocarcinoma.

ABSTRACT: BACKGROUND:Barrett's esophagus (BE) is the premalignant lesion of esophageal adenocarcinoma (EAC) and is the target of early detection and prevention efforts for EAC. AIMS:We sought to evaluate what proportion and temporal trends of EAC patients had missed opportunities for screening and surveillance of BE. METHODS:Our study included 182 patients with EAC at the Michael E. DeBakey VA Medical Center in Houston, Texas, between 02/2005 and 09/2017. We conducted a retrospective audit of patients' medical records for any previous upper endoscopies (EGDs) for screening or surveillance of BE prior to their EAC diagnosis. RESULTS:The mean age of the cohort was 67.3 years (SD?=?9.5); 99.5% of patients were male, and 85.2% were white. Only 45 patients (24.7%) had EGD at any time prior to the cancer diagnosing EGD, of whom 29 (15.9% of all EAC cases) had an established BE diagnosis. In the 137 patients with no prior EGD, most (63.5%) had GERD or were obese or ever smokers. There were no changes in patterns over time. For the 29 patients with prior established BE, 22 (75.8%) were diagnosed with EAC as a result of surveillance EGD. Patients with prior established BE were more likely to be diagnosed at 0 or I stage (p?

SUBMITTER: Hammad TA

PROVIDER: S-EPMC6358496 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Missed Opportunities for Screening and Surveillance of Barrett's Esophagus in Veterans with Esophageal Adenocarcinoma.

Hammad Tariq A TA Thrift Aaron P AP El-Serag Hashem B HB Husain Nisreen S NS

Digestive diseases and sciences 20181028 2

<h4>Background</h4>Barrett's esophagus (BE) is the premalignant lesion of esophageal adenocarcinoma (EAC) and is the target of early detection and prevention efforts for EAC.<h4>Aims</h4>We sought to evaluate what proportion and temporal trends of EAC patients had missed opportunities for screening and surveillance of BE.<h4>Methods</h4>Our study included 182 patients with EAC at the Michael E. DeBakey VA Medical Center in Houston, Texas, between 02/2005 and 09/2017. We conducted a retrospective ...[more]

PMID: 30370493

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Project description:Esophageal adenocarcinoma (EAC) is thought to develop from asymptomatic Barrett's esophagus (BE) with a low annual rate of conversion. Current endoscopy surveillance of BE patients is probably not cost-effective. Previously, we discovered serum glycoprotein biomarker candidates which could discriminate BE patients from EAC. Here, we aimed to validate candidate serum glycoprotein biomarkers in independent cohorts, and to develop a biomarker candidate panel for BE surveillance. Serum glycoprotein biomarker candidates were measured in 301 serum samples collected from Australia (4 states) and the United States (1 clinic) using previously established lectin magnetic bead array (LeMBA) coupled multiple reaction monitoring mass spectrometry (MRM-MS) tier 3 assay. The area under receiver operating characteristic curve (AUROC) was calculated as a measure of discrimination, and multivariate recursive partitioning was used to formulate a multi-marker panel for BE surveillance. Complement C9 (C9), gelsolin (GSN), serum paraoxonase/arylesterase 1 (PON1) and serum paraoxonase/lactonase 3 (PON3) were validated as diagnostic glycoprotein biomarkers in lectin pull-down samples for EAC across both cohorts. A panel of 10 serum glycoprotein biomarker candidates discriminated BE patients not requiring intervention (BE± low grade dysplasia) from those requiring intervention (BE with high grade dysplasia (BE-HGD) or EAC) with an AUROC value of 0.93. Tissue expression of C9 was found to be induced in BE, dysplastic BE and EAC. In longitudinal samples from subjects that have progressed toward EAC, levels of serum C9 were significantly (p < 0.05) increased with disease progression in EPHA (erythroagglutinin from Phaseolus vulgaris) and NPL (Narcissus pseudonarcissus lectin) pull-down samples. The results confirm alteration of complement pathway glycoproteins during BE-EAC pathogenesis. Further prospective clinical validation of the confirmed biomarker candidates in a large cohort is warranted, prior to development of a first-line BE surveillance blood test.

Dataset Information

Missed Opportunities for Screening and Surveillance of Barrett's Esophagus in Veterans with Esophageal Adenocarcinoma.

Publications

Missed Opportunities for Screening and Surveillance of Barrett's Esophagus in Veterans with Esophageal Adenocarcinoma.

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