A multicenter, double-blinded validation study of methylation biomarkers for progression prediction in Barrett's esophagus.

Abstact

Esophageal adenocarcinoma risk in Barrett's esophagus (BE) is increased 30- to 125-fold versus the general population. Among all BE patients, however, neoplastic progression occurs only once per 200 patient-years. Molecular biomarkers are therefore needed to risk-stratify patients for more efficient surveillance endoscopy and to improve the early detection of progression. We therefore performed a retrospective, multicenter, double-blinded validation study of eight BE progression prediction methylation biomarkers. Progression or nonprogression were determined at 2 years (tier 1) and 4 years (tier 2). Methylation was assayed in 145 nonprogressors and 50 progressors using real-time quantitative methylation-specific PCR. Progressors were significantly older than nonprogressors (70.6 versus 62.5 years; P < 0.001). We evaluated a linear combination of the eight markers, using coefficients from a multivariate logistic regression analysis. Areas under the ROC curve (AUC) were high in the 2-year, 4-year, and combined data models (0.843, 0.829, and 0.840; P < 0.001, <0.001, and <0.001, respectively). In addition, even after rigorous overfitting correction, the incremental AUCs contributed by panels based on the 8 markers plus age versus age alone were substantial (Delta-AUC = 0.152, 0.114, and 0.118, respectively) in all 3 models. A methylation biomarker-based panel to predict neoplastic progression in BE has potential clinical value in improving both the efficiency of surveillance endoscopy and the early detection of neoplasia.

Authors
  • Abraham JM
  • Agarwal R
  • Bhattacharyya A
  • Canto MI
  • Cheng Y
  • David S
  • Feng Z
  • Gu W
  • Hamilton JP
  • Ito T
  • Jin Z
  • Kan T
  • Meltzer SJ
  • Mori Y
  • Nelson MA
  • Olaru AV
  • Paun BC
  • Romero Y
  • Sampliner RE
  • Sato F
  • Selaru FM
  • Shaheen NJ
  • Wagner PD
  • Wallace MB
  • Wang J
  • Wang KK
  • Washington K
  • Wolfsen HC
  • Yang J
  • Zheng Y
PubMed ID
Appears In
Cancer Res, 2009, 69 (10)