@entity5 detected at a late stage are often refractory to treatments and ultimately lethal. Early detection can significantly increase survival probability, but attempts to reduce mortality by early detection have frequently increased overdiagnosis of indolent conditions that do not progress over a lifetime. Study designs that incorporate biomarker trajectories in time and space are needed to distinguish @entity1 who progress to an early @entity5 from those who follow an indolent course. @entity420 is characterized by evolution of punctuated and catastrophic somatic chromosomal alterations and high levels of overall mutations but few recurrently mutated genes aside from @entity876 . Endoscopic surveillance of @entity355 for early @entity5 detection provides an opportunity for assessment of alterations for @entity5 risk in @entity1 who progress to @entity420 compared with nonprogressors. We investigated 1,272 longitudinally collected esophageal biopsies in a 248 Barrett's @entity1 case-cohort study with 20,425 @entity1 -months of follow-up, including 79 who progressed to early-stage @entity420 . @entity5 progression risk was assessed for total chromosomal alterations, diversity, and chromosomal region-specific alterations measured with single-nucleotide polymorphism arrays in biopsies obtained over esophageal space and time. A model using 29 chromosomal features was developed for @entity5 risk prediction (area under receiver operator curve, 0.94). The model prediction performance was robust in two independent @entity420 sets and outperformed @entity876 mutation, flow cytometric DNA content, and histopathologic diagnosis of @entity1141 . This study offers a strategy to reduce overdiagnosis in @entity355 and improve early detection of esophageal @entity5 characterized by punctuated and catastrophic chromosomal evolution.

Assessment of @entity420 Risk Using Somatic Chromosome Alterations in Longitudinal Samples in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'person'] @entity355 :: ('MESH:D001471', 'Disease') :: ["Barrett's esophagus"] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancers', 'cancer', 'adenocarcinoma and potentially other cancers', 'Cancer'] @entity876 :: ('7157', 'Gene') :: ['TP53'] @entity420 :: ('MESH:D000230', 'Disease') :: ['esophageal adenocarcinoma', 'Esophageal adenocarcinoma'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity355 :: (MESH:D001471,Disease) :: ['Barrett's Esophagus']
