Interventional gastroenterology

Sponge on string may reduce endoscopies in Barrett’s oesophagus

A pill that expands into a small foam sponge when swallowed could be used by clinicians to identify people with Barrett’s oesophagus who are at a low risk of oesophageal cancer.

The cytosponge could mean that for some patients surveillance endoscopies could be avoided, say the researchers from Cancer Research UK in their paper published in The Lancet Gastroenterology and Hepatology. 

The researchers used the cytosponge in 468 patients with Barrett’s oesophagus and tested the collected cells for three protein biomarkers (P53, c-Myc, and Aurora kinase A), two methylation markers (MYOD1 and RUNX3), glandular atypia, and TP53 mutation status.

They then used the results, alongside clinical and demographic factors, to classify patients’ risk levels.

Overall 162 (45%) of the patients were considered low-risk under this model – defined as having a 100% probability of being a true non-dysplastic patient and a 0% probability of having high grade dysplasia or intramuscular carcinoma.

“A combination of biomarker assays from a single cytosponge sample can be used to determine a group of patients at low risk of progression, for whom endoscopy could be avoided.

This strategy could help to avoid overdiagnosis and overtreatment in patients with Barrett’s oesophagus,” the authors concluded. 

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