P110 Cytosponge for risk stratification in patients with Barrett's oesophagus overdue endoscopic surveillance due to COVID-19. (19th June 2022)

• Record Type: Journal Article
• Authors: Sehgal, Vinay; Aslam, Nasar; McGuire, Joshua; Telese, Andrea; Hussein, Mohamed; Naidoo, Dashnee; Coates, Olivia; Thorpe, Sally; Brogden, Sara; Makahamadze, Christwishes; Sesay, Michael; Mitchison, Miriam; Jansen, Marnix; Sweis, Rami; Banks, Matthew; Graham, David; Lovat, Laurence; Haidry, Rehan
• Is Part Of: Gut. Volume 71(2022)Supplement 1
• Page Start: A95
• Page End: A95
• Publication Date: 2022-06-19
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-BSG.167
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: At the onset of the COVID-19 pandemic, based on BSG guidelines, all patients undergoing endoscopic surveillance for Barrett's Oesophagus (BE) were indefinitely postponed. As well as the potential for missed progression to dysplasia, the negative impact on patients' quality of life is immeasurable. The Cytosponge® is a minimally invasive cell sampling device which to date has been researched in screening for BE. We describe the first use of the Cytosponge® outside of a clinical trial to support the triage of BE surveillance patients. Methods: Consecutive patients with non-dysplastic BE (NDBE) or those deemed to be low risk after previous treatment for BE-related dysplasia, DBE, with no prior history of stenosis were invited to have the Cytosponge®. The sample was analysed for TFF3 (a marker of intestinal metaplasia), cellular atypia and p53. Results: To date, 153 patients (mean age 66 years, 126 male) have undergone the Cytosponge® procedure. The median maximal length of BE was 3cm (1-15cm). Three patients were unable to swallow the device and 19 (12%) needed a repeat procedure as no columnar cells were present. 87 patients (80%) with NDBE had a either a low-risk result (TFF3 positive only – 62) or required a repeat Cytosponge® routinely (TFF3/atypia/p53 negative – 25). The remaining 21 patients (20%) needed an endoscopy within 3 months of the Cytosponge®. 17 of these patients have since had an endoscopy of which 4 had a new diagnosis of dysplasia (low grade dysplasia, indefinite, INDEF 2, LGD – 1; intramucosal, IMC - 1) and 2 a new diagnosis of cancer. 18 patients in the low-risk ND-BE cohort have undergone follow-up endoscopy (ND-BE 17/18, HGD 1/18). of the 23 patients in the post-treatment cohort, only 1 patient had a high-risk result and subsequent endoscopy confirmed HGD ( Table 1 ). Over-expression of p53 appeared to be the most sensitive marker (p - 0.01). Conclusions: Cytosponge® has proved to be a useful non-endoscopic tool for patients with BE under surveillance. Preliminary data are promising to detect dysplasia and triage patients to endoscopy early. Further large scale, longitudinal endoscopic follow-up is needed.