Desai et al8 relied on 16 studies with a total of 967 patients, whereas Thomas et al10 included 6 studies with a combined number of 258 patients with SSBE. with short (1 and 3) and long (3) BE lengths using log-rank assessments. A subgroup analysis was performed on patients with a documented Prague C&M classification. We used a multivariable proportional hazards model to evaluate the association between BE length and progression. Adjusted hazards ratios were calculated after adjusting for variables associated with progression. Rosabulin RESULTS: We found 822 patients to have a short-segment BE (SSBE) and 1061 to have long segment BE (LSBE). We found patients with SSBE to have a significantly lower annual rate of progression to EAC (0.07%) than of patients with LSBE (0.25%) ( .001). This effect persisted in multivariable analysis (hazard ratio, 0.32; 95% CI, 0.18C0.57; .001). CONCLUSION: We analyzed progression of BE (length 1 cm) to HGD or EAC in a large cohort of patients seen at multiple centers and followed for a median 6.4 years. We found a lower annual rate of progression of SSBE to EAC (0.07%/year) than of LSBE (0.25%/year). We propose lengthening current surveillance intervals for patients with SSBE. test and chi-square as appropriate. A multivariable proportional hazards model was used to derive an adjusted association between BE length and progression. Adjusted hazard ratio (HR) was calculated after adjusting for variables known to be associated with progression: gender, smoking, age, BMI, and hiatal hernia. A subgroup analysis of patients with documented Prague C&M was also performed. All analyses were performed using SAS version 9.4 (SAS Rosabulin Institute, Cary, NC), and a value of .05 was considered statistically significant. Results Demographics, Comorbidities, and Medication Use A total of 1883 patients with NDBE were identified (mean age 57.3 years, 83.5% men, 88.1% Caucasian) (Table 1). The mean length of BE in the entire cohort was 3.9 3.0 cm and 75.3% patients had a hiatal hernia. Both patient groups had a similar burden of comorbidities (diabetes, hypertension) and comparable rates of smoking (Table 1). There was no difference in proton pump inhibitor use (96% in both); however, patients with SSBE CD69 had higher rates of aspirin and statin use ( .001) (Table 1). Table 1. Baseline Patient Characteristics, Comorbidities, Medications, and BE length value= .001) respectively (Table 2). For a combined endpoint of HGD or EAC, the annual progression rates were also significantly lower in the SSBE cohort compared with LSBE patients (0.29% vs 0.91%; .001) (Table 2). To note, none of the 182 patients in the SIM 1 cm group progressed to HGD or Rosabulin EAC. The median number of endoscopic exams was 4.0 (range, 2.0C5.0) for SSBE vs 4.0 (range, 3.0C6.0) for LSBE. Table 2. Yearly Progression in Short- and Long Segment BE value= .19). The annual rate of progression to HGD or EAC in the SSBE group was 0.35% vs 0.78% in the LSBE group (= .007) (Table 3). Table 3. Progression Among Patients With Prague Classification Value .001). This also held true in patients with documented Prague classification (HR, 0.36; 95% confidence Rosabulin interval, 0.2C0.67; = .001) (Table 4). Table 4. Adjusted Hazard Ratio Rosabulin for Short- vs Long-Segment BE value /th /thead Total cohort0.32 (0.18C0.57) .001With Prague data0.36 (0.20C0.67).001 Open in a separate window NOTE. Values are hazard ratio (95% confidence interval). Adjusted for age, sex, race, and smoking. Discussion Using the updated definition of BE from recent guidelines, analysis of this multicenter cohort of 1883 patients with nondysplastic BE, over a mean follow-up of 6.4 years, demonstrates a significantly low rate of progression to HGD or EAC in SSBE in comparison to LSBE patients. The annual progression rate from NDBE to EAC for SSBE was significantly lower at 0.07% as compared with 0.25% for LSBE. Similarly, for the combined endpoint of HGD or EAC, rates of progression remained significantly lower in SSBE at 0.29% vs 0.91% for LSBE. After adjusting for multiple risk factors, the rate of progression to HGD or EAC was still significantly lower in SSBE in comparison to LSBE with HR of 0.32, suggesting a 68% lower risk of progression to HGD or EAC in those with segment lengths of 1 1 cm and 3 cm. It is important to also note that none of the patients in the SIM 1 cm group progressed to HGD or EAC. These results corroborate the findings of other studies that have also noted a low progression rate to HGD or EAC in SSBE patients. A recent study by Pohl et al15 with 240 patients with SSBE and 573 with LSBE, showed the annual cancer risk to.
- T-cell epitopes are peptides derived from antigens and identified by the T-cell receptor (TCR) when bound to MHC molecules displayed within the cell surface of APCs
- Cloning of gene fragments encoding diagnostic antigens
- Epitopes are present on a single HLA (private epitope) or shared by multiple antigens (public epitope)
- Spleens were harvested in 1 (C) or 2 wpi (B, C) and cells were analyzed by movement cytometry in comparison to na?ve mice
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