{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:28:21Z","timestamp":1761895701719},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,9,5]],"date-time":"2013-09-05T00:00:00Z","timestamp":1378339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the value of \u03b1\u2010methylacyl\u2010CoA racemase (<jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content>) immunohistochemistry for predicting neoplastic progression in Barrett's oesophagus (<jats:styled-content style=\"fixed-case\">BO<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We conducted a case\u2013control study within a prospective cohort of 720 <jats:styled-content style=\"fixed-case\">BO<\/jats:styled-content> patients. Patients who developed high\u2010grade dysplasia or oesophageal adenocarcinoma were classified as cases, and patients without neoplastic progression as controls. <jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content> expression was determined by immunohistochemistry in 12\u00a0127 biopsies from 635 patients, and was scored independently by two expert pathologists. Relative risks adjusted for age, gender, <jats:styled-content style=\"fixed-case\">BO<\/jats:styled-content> length and oesophagitis (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content><jats:sup>a<\/jats:sup>) were calculated in log\u2010linear models. During a median follow\u2010up of 6.6\u00a0years, 49 patients (8%) developed high\u2010grade dysplasia or oesophageal adenocarcinoma. Although mild <jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content> expression was associated with a trend towards an increased risk of neoplastic progression (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content><jats:sup>a<\/jats:sup> 1.6, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.9\u20133.1), the risk was especially elevated with strong <jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content> expression (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content><jats:sup>a<\/jats:sup> 4.8, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.9\u201312.6). The positive predictive value of strong <jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content> expression was slightly higher than that of low\u2010grade dysplasia (22% versus 15%); the negative predictive value was slightly lower (91% versus 93%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Strong <jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content> expression is associated with an increased risk of neoplastic progression in <jats:styled-content style=\"fixed-case\">BO<\/jats:styled-content>. However, <jats:styled-content style=\"fixed-case\">AMACR<\/jats:styled-content> expression appears to be a less powerful predictor for neoplastic progression than low\u2010grade dysplasia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12216","type":"journal-article","created":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T06:02:51Z","timestamp":1372658571000},"page":"630-639","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Value of \u03b1\u2010methylacyl\u2010CoA racemase immunochemistry for predicting neoplastic progression in Barrett's oesophagus"],"prefix":"10.1111","volume":"63","author":[{"given":"Florine","family":"Kastelein","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Biermann","sequence":"additional","affiliation":[{"name":"Department of Pathology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewout W","family":"Steyerberg","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Verheij","sequence":"additional","affiliation":[{"name":"Department of Pathology Academic Medical Centre Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marit","family":"Kalisvaart","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leendert H J","family":"Looijenga","sequence":"additional","affiliation":[{"name":"Department of Pathology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans A","family":"Stoop","sequence":"additional","affiliation":[{"name":"Department of Pathology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurens","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Pathology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernst J","family":"Kuipers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manon C W","family":"Spaander","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco J","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Erasmus University Medical Centre Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"ProBar study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.33427"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.176701"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.10.010"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(89)80011-3"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.08.053"},{"key":"e_1_2_5_7_1","first-page":"1","article-title":"Predicting neoplastic progression in Barrett's esophagus","volume":"1","author":"Wang JS","year":"2010","journal-title":"Ann. 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