title: Combining aneuploidy and dysplasia for colitis' cancer risk assessment outperforms current surveillance efficiency: a meta-analysis.
abstract: OBJECTIVE
  Cancer risk assessment for ulcerative colitis patients by evaluating histological changes through colonoscopy surveillance is still challenging. Thus, additional parameters of high prognostic impact for the development of colitis-associated carcinoma are necessary. This meta-analysis was conducted to clarify the value of aneuploidy as predictor for individual cancer risk compared with current surveillance parameters.
  
  
  METHODS
  A systematic web-based search identified studies published in English that addressed the relevance of the ploidy status for individual cancer risk during surveillance in comparison to neoplastic mucosal changes. The resulting data were included into a meta-analysis, and odds ratios (OR) were calculated for aneuploidy or dysplasia or aneuploidy plus dysplasia.
  
  
  RESULTS
  Twelve studies addressing the relevance of aneuploidy compared to dyplasia were comprehensively evaluated and further used for meta-analysis. The meta-analysis revealed that aneuploidy (OR 5.31 [95 % CI 2.03, 13.93]) is an equally effective parameter for cancer risk assessment in ulcerative colitis patients as dysplasia (OR 4.93 [1.61, 15.11]). Strikingly, the combined assessment of dysplasia and aneuploidy is superior compared to applying each parameter alone (OR 8.99 [3.08, 26.26]).
  
  
  CONCLUSIONS
  This meta-analysis reveals that aneuploidy is an equally effective parameter for individual cancer risk assessment in ulcerative colitis as the detection of dysplasia. More important, the combined assessment of dysplasia and aneuploidy outperforms the use of each parameter alone. We suggest image cytometry for ploidy assessment to become an additional feature of consensus criteria to individually assess cancer risk in UC.
authors.affiliation: Section for Translational Surgical Oncology and Biobanking, Department of Surgery, University of Lübeck and University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.|Section of Cancer Genomics, Genetics Branch, National Cancer Institute, National Institutes of Health, 50 South Drive, Bethesda, MD, 20892, USA.
authors.forename: Rüdiger
authors.identifier: http://orcid.org/0000-0002-1662-2109
authors.initials: R
authors.lastname: Meyer
authors.affiliation: Institute of Medical Informatics and Statistics, University Medical Center Schleswig-Holstein, Campus Kiel, Brunswiker Straße 10, 24105, Kiel, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Freitag-Wolf
authors.affiliation: Section for Translational Surgical Oncology and Biobanking, Department of Surgery, University of Lübeck and University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Blindow
authors.affiliation: Unit of Gastroenterology, Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Büning
authors.affiliation: Section for Translational Surgical Oncology and Biobanking, Department of Surgery, University of Lübeck and University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. Jens.Habermann@uksh.de.
authors.forename: Jens K
authors.initials: JK
authors.lastname: Habermann
mesh_terms: D000782:Aneuploidy; D003093:Colitis, Ulcerative / Q000150:complications*; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D004247:DNA / Q000235:genetics; D018450:Disease Progression; D005819:Genetic Markers; D006801:Humans; D016017:Odds Ratio; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D005819:Genetic Markers; D004247:DNA
keywords: Cancer risk assessment; Meta-analysis; Nuclear DNA ploidy; Ulcerative colitis-associated colorectal carcinoma