Capsule Sponge + Biomarkers Can Stratify Risk in Barrett Esophagus

MONDAY, June 30, 2025 (HealthDay News) -- In adult patients with nondysplastic Barrett esophagus at last endoscopy, a subsequent capsule-sponge test can assist in identifying those at highest risk of dysplasia or cancer, according to a study published online June 23 in The Lancet.W. Keith Tan, M.B.Ch.B., from Cambridge University in the United Kingdom, and colleagues prospectively evaluated a prespecified risk stratification tool -- comprising a pan-esophageal cell collection device coupled with biomarkers -- to establish whether it can identify those at highest risk of dysplasia or cancer. Adult patients with nondysplastic Barrett esophagus at their last endoscopy had a capsule-sponge test and were assigned as low, moderate, or high risk.A total of 910 patients were recruited, 15, 31, and 54 percent were classified as high, moderate, and low risk, respectively. The researchers found that in the high-risk group, the positive predictive value for any dysplasia or worse was 37.7 percent. The highest risk of high-grade dysplasia or cancer was seen for patients with both atypia and aberrant p53 (relative risk, 135.8 relative to the low-risk group). In the low-risk group, the prevalence of high-grade dysplasia or cancer was 0.4 percent; the negative predictive value was 97.8 percent for any dysplasia or cancer. The proportion needing p53 pathology review could be reduced to 32 percent, without missing any positive cases, by applying a machine learning algorithm as part of a digital pathology workflow."The capsule sponge can be administered easily and quickly by nurses with only limited training required and will not need to take up precious endoscopy resources," Tan said in a statement.Several authors who are named on patents related to this test disclosed ties to Cyted Health and Medtronic. Medtronic holds the license for the cytosponge technology.Abstract/Full Text.Sign up for our weekly HealthDay newsletter