MIC-1/GDF15 in Barrett's oesophagus and oesophageal adenocarcinoma

摘要

Background: Biomarkers are needed to improve current diagnosis and surveillance strategies for patients with Barrett's oesophagus (BO) and oesophageal adenocarcinoma (OAC). Macrophage inhibitory cytokine 1/growth differentiation factor 15 (MIC-1/GDF15) tissue and plasma levels have been shown to predict disease progression in other cancer types and was therefore evaluated in BO/OAC. Methods: One hundred thirty-eight patients were studied: 45 normal oesophagus (NE), 37 BO, 16 BO with low-grade dysplasia (LGD) and 40 OAC. Results: Median tissue expression of MIC-1/GDF15 mRNA was ?25-fold higher in BO and LGD compared to NE ( P <0.001); two-fold higher in OAC vs BO ( P =0.039); and 47-fold higher in OAC vs NE ( P 720 discriminated between the presence of either OAC or LGD vs NE with 94% sensitivity and 71% specificity (ROC AUC 0.86, 95% CI 0.73–0.96; P <0.001). Macrophage inhibitory cytokine 1/growth differentiation factor 15 plasma values were also elevated in patients with OAC vs NE ( P <0.001) or BO ( P =0.015). High MIC-1/GDF15 plasma levels (?1140?pg?ml~(?1)) were an independent predictor of poor survival for patients with OAC (HR 3.87, 95% CI 1.01–14.75; P =0.047). Conclusions: Plasma and tissue levels of MIC-1/GDF15 are significantly elevated in patients with BO, LGD and OAC. Plasma MIC-1/GDF15 may have value in diagnosis and monitoring of Barrett's disease.