New Minimally Invasive Test IDs Patients for Barrett's Esophagus Screening

A new minimally invasive cell sampling device, Cytosponge-TFF3, coupled with assessment of trefoil factor 3 expressions, can successfully identify patients with reflux symptoms who warrant endoscopy to diagnose Barrett's esophagus.

According to a study published in PLOS Medicine by Rebecca Fitzgerald and colleagues from the MRC Cancer Unit, UK, researchers evaluated the safety, acceptability, and accuracy of the minimally invasive test command pared it with endoscopy for the diagnosis of Barrett's esophagus.

The team observed investigational endoscopy of dyspepsia and reflux symptoms in a total of 1,110 eligible individuals attending 11 UK hospitals. The results highlighted that Cytosponge-TFF3 actually did correctly identify 79.9% of the 647 individuals with endoscopically diagnosed Barrett's esophagus. Additionally, they found 92.4% of 463 individuals were correctly identified as being unaffected by Barrett’s esophagus.

The sensitivity of the test increased to 87.2% for patients with circumferential Barrett's segments of more than 3 cm. Furthermore, nearly 94% of the participants successfully swallowed the sampling device.

The team noted there were no adverse effects attributed to the device, and participants who swallowed the device generally rated the experience as acceptable.

While the findings indicated that Cytosponge-TFF3 is safe and acceptable, and has accuracy comparable to other screening tests, the researchers do agree future randomized controlled trials of the test are necessary to assess its “suitability for clinical implementation.” They also suggested incorporating more biomarkers to smoothly identify those who possessing the greatest risk of esophageal cancer, and thereby avoid overtreatment of Barrett's esophagus.

The authors concluded, “The Cytosponge-TFF3 test can diagnose [Barrett's esophagus] in a manner that is acceptable to patients and logistically feasible across multiple centers. This test may substantially lower the threshold for investigating patients with reflux, as part of a strategy to reduce population mortality from esophageal adenocarcinoma.”