title: MIC-1/GDF15 in Barrett's oesophagus and oesophageal adenocarcinoma.
abstract: 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<0.001). Relative MIC-1/GDF15 tissue expression >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.
authors: St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia.
authors: O M
authors: OM
authors: Fisher
authors: St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia.
authors: A J
authors: AJ
authors: Levert-Mignon
authors: 1] St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia [2] NHMRC Clinical Trials Centre University of Sydney, Sydney, NSW 2050, Australia [3] Department of Epidemiology and Medical Statistics, School of Medicine, University of Notre Dame, Sydney, NSW 2010 Australia.
authors: S J
authors: SJ
authors: Lord
authors: St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia.
authors: K K M
authors: KK
authors: Lee-Ng
authors: St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia.
authors: N K
authors: NK
authors: Botelho
authors: 1] St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia [2] Department of Surgery, Lund University Hospital (Skåne University Hospital) and Lund University, Lund 221 85, Sweden.
authors: D
authors: D
authors: Falkenback
authors: St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia.
authors: M L
authors: ML
authors: Thomas
authors: 1] St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia [2] Faculty of Medicine, School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors: Y V
authors: YV
authors: Bobryshev
authors: QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors: D C
authors: DC
authors: Whiteman
authors: 1] St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia [2] Peter Duncan Neuroscience Research Unit, St Vincent's Centre for Applied Medical Research, Sydney, NSW 2010 Australia.
authors: D A
authors: DA
authors: Brown
authors: St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia.
authors: S N
authors: SN
authors: Breit
authors: 1] St Vincent's Centre for Applied Medical Research and University of New South Wales, Sydney, NSW 2010 Australia [2] Department of Surgery, School of Medicine, University of Notre Dame, Sydney, NSW 2010 Australia.
authors: R V
authors: RV
authors: Lord
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D000368:Aged; D001471:Barrett Esophagus / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15