Statistical evaluation of individual participants in blinded study evaluating MRI and endoscopy.

<p>*Negative values indicate less than chance agreement.</p

Accuracy assessment of MRI and endoscopy.

<p>A, The graph shows percent accuracy of individual scans when assessed by each technique: visual endoscopy and MRI. B, The graph compares average accuracy of each technique as evaluated by the blinded study. MRI; magnetic resonance imaging.</p

Comparative analysis of a single animal with histology, endoscopy and MRI.

<p>A, Hemotoxylin and eosin staining (magnification×10) shows histological confirmation of EAC. B, Endoscopic evaluation of the same rat. Arrow designates suspected area of tumor identified by endoscopic study participants. C, Axial MRI assessment. The arrow shows an abnormal mass on esophageal wall selected by MRI study participants. D, Coronal MRI image. Arrow identifies corresponding cross section of suspected tumor in anastomotic area of interest. MRI; magnetic resonance imaging, EAC; esophageal adenocarcinoma.</p

The Levrat Model.

<p>Gross image of esophageal tumor (animal no. 13) induced by modified Levrat model.</p

ROC curves of MRI and endoscopic evaluation.

<p>A, ROC curve of average endoscopic reading (AUC = 0.534; SE = 0.138; asymptotic significance = 0.80; 95% confidence interval, 0.263–0.805). B, ROC curve of average MRI reading. (AUC = 0.966; SE = 0.036; asymptotic significance <.001; 95% confidence interval, 0–1.0). ROC; receiver operating characteristic, AUC; area under curve, SE; standard error.</p

Kaplan-Meier survival curve based on high and low risk groups.

<p>Kaplan-Meier survival curves were generated for high and low risk groups based on adjacent squamous epithelial survivin CASE expression. The high-risk group demonstrated an association with increased mortality, although the correlation did not reach significance. Kaplan-Meier analysis for tumor survivin high and low risk groups yielded similar results (p = 0.11).</p

Survivin inhibition pathway.

<p>Survivin binds to and inhibits caspase 9, caspase 9 is unable to cleave caspase 3, caspase 3 is unable to cleave PARP, PARP promotes DNA repair and does not induce apoptosis.</p

A: Reverse transcriptase polymerase chain reaction of siRNA inhibition of survivin in EAC cell line.

<p>OE19 and OE33 EAC cell lines were transfected with siRNA and survivin expression was analyzed between control and transfected cell lines. Both cell lines transfected with siRNA showed clear inhibition and downregulation of survivin expression. <b>B: Western blot of siRNA inhibition of survivin in EAC cell line.</b> siRNA was incubated with OE19 and OE33 cell lines to inhibit survivin expression. β-Actin was used as a loading control. Survivin was downregulated, while downstream apoptotic proteins cleaved caspase 3 and cleaved PARP were upregulated. The upregulation of downstream apoptotic proteins indicates apoptosis occurs through incubation with siRNA.</p

Quantitative real time polymerase chain reaction (qRT-PCR) of patient survivin levels.

<p>A: qRT-PCR was performed to compare survivin expression between tumor and adjacent squamous epithelial tissue. B: On average, tumor samples showed 3× greater survivin expression than paired adjacent tissue.</p

Immunohistochemistry of survivin in human tissue.

<p>Survivin expression was evaluated through IHC staining, tumor tissue and adjacent squamous epithelium showed presence of staining indicative of survivin expression. Arrows represent positive staining.</p