Cytosponge in screening for Barrett's oesophagus

Cytosponge

• Cytosponge is a non-endoscopic diagnostic tool that was developed to detect Barrett's oesophagus in patients with reflux symptoms
  
  • consists of a tethered capsule that is swallowed in a primary or secondary care office setting and collects oesophageal cells, which can be assessed for morphology and immunohistochemical biomarkers of intestinal metaplasia (TFF3) and dysplasia (atypia and p53) (1)
    
• non-endoscopic oesophageal cell collection device known as the Cytosponge, coupled with a biomarker test for trefoil factor 3 (TFF3), has been shown to increase detection of Barrett's oesophagus ten times over the current standard of care (2)
  
• the BEST3 study is summarised (3):
  • the study authors concluded that:
    • in patients with gastro-oesophageal reflux, the offer of Cytosponge-TFF3 testing results in improved detection of Barrett's oesophagus
      
• CRUK states (4)
  • the kit includes a small capsule containing a sponge attached to a surgical string
  • the patient swallows the capsule, which dissolves in their stomach
  • the sponge is retrieved by the health professional after a few minutes by pulling on the string
  • as the sponge moves up through the oesophagus it collects cells from the oesophageal lining which are analysed by pathologists in a laboratory for markers of Barrett’s oesophagus or oesophageal cancer

Reference:

1. di Pietro M, Modolell I, O'Donovan M, Price C, Pilonis ND, Debiram-Beecham I, Fitzgerald RC. Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic. Lancet Gastroenterol Hepatol. 2020 Sep;5(9):805-806. doi: 10.1016/S2468-1253(20)30242-9.
2. Pilonis ND, Killcoyne S, Tan WK, O'Donovan M, Malhotra S, Tripathi M, Miremadi A, Debiram-Beecham I, Evans T, Phillips R, Morris DL, Vickery C, Harrison J, di Pietro M, Ortiz-Fernandez-Sordo J, Haidry R, Kerridge A, Sasieni PD, Fitzgerald RC. Use of a Cytosponge biomarker panel to prioritise endoscopic Barrett's oesophagus surveillance: a cross-sectional study followed by a real-world prospective pilot. Lancet Oncol. 2022 Feb;23(2):270-278.
3. Fitzgerald RC, di Pietro M, O'Donovan M, Maroni R, Muldrew B, Debiram-Beecham I, Gehrung M, Offman J, Tripathi M, Smith SG, Aigret B, Walter FM, Rubin G; BEST3 Trial team; Sasieni P. Cytosponge-trefoil factor 3 versus usual care to identify Barrett's oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial. Lancet. 2020 Aug 1;396(10247):333-344
4. CRUK. Capsule sponge testing and oesophageal cancer diagnosis.