A device called Cytosponge could be used to identify patients with Barrett oesophagus at low-risk of disease progression, according to the BEST2 study group. Cytosponge is a foam sphere within a gelatine capsule on a string that expands in the stomach after swallowing. When pulled from the stomach, the sponge enables collection of cells along the entire oesophagus, minimizing sampling bias. A multicentre discovery cohort of patients with Barrett oesophagus (n = 468) were tested with Cytosponge to identify clinical and molecular biomarkers that could stratify patients by risk. The optimum panel consisted of age, Barrett segment length, BMI, TP53 mutation status, Aurora kinase A expression and presence of glandular atypia. The model was validated in an independent cohort (n = 65), scoring 38% at low-risk for malignant progression. These patients could be spared invasive and expensive endoscopic surveillance, enabling prioritization for those at higher risk.
Ross-Innes, C. S. et al. Risk stratification of Barrett's oesophagus using non-endoscopic sampling method coupled with a biomarker panel: a cohort study. Lancet Gasterol. Hepatol. http://dx.doi.org/10.1016/S2468-1253(16)30118-2 (2016)
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Dickson, I. Risk stratification using Cytosponge. Nat Rev Gastroenterol Hepatol 14, 4 (2017). https://doi.org/10.1038/nrgastro.2016.203
Annals of the New York Academy of Sciences (2018)