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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The Tissue Systems Pathology Test Outperforms Pathology Review in Risk Stratifying Patients With Low-Grade Dysplasia
Gastroenterology, Volume 165, No. 5, Year 2023
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Description
Background & Aims: Low-grade dysplasia (LGD) is associated with an increased risk of progression in Barrett's esophagus (BE); however, the diagnosis of LGD is limited by substantial interobserver variability. Multiple studies have shown that an objective tissue systems pathology test (TissueCypher Barrett's Esophagus Test, TSP-9), can effectively predict neoplastic progression in patients with BE. This study aimed to compare the risk stratification performance of the TSP-9 test vs benchmarks of generalist and expert pathology. Methods: A blinded cohort study was conducted in the screening cohort of a randomized controlled trial of patients with BE with community-based LGD. Biopsies from the first endoscopy with LGD were assessed by the TSP-9 test and independently reviewed by 30 pathologists from 5 countries per standard practice. The accuracy of the test and the diagnoses in predicting high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) were compared. Results: A total of 154 patients with BE (122 men), mean age 60.9 ± 9.8 years were studied. Twenty-four patients progressed to HGD/EAC within 5 years (median time of 1.7 years) and 130 did not progress to HGD/EAC within 5 years (median 7.8 years follow-up). The TSP-9 test demonstrated higher sensitivity (71% vs mean 63%, range 33%–88% across 30 pathologists), than the pathology review in detecting patients who progressed (P = .01186). Conclusions: The TSP-9 test outperformed the pathologists in risk stratifying patients with BE with LGD. Care guided by the test can provide an effective solution to variable pathology review of LGD, improving health outcomes by upstaging care to therapeutic intervention for patients at high risk for progression, while reducing unnecessary interventions in low-risk patients. © 2023 The Authors
Authors & Co-Authors
Montgomery, Elizabeth Anne
United States, Coral Gables
University of Miami
Kate, Fiebo J.W.Ten
Netherlands, Utrecht
University Medical Center Utrecht
Chetty, Runjan M.
Unknown Affiliation
Feakins, Roger M.
United Kingdom, London
The Royal Free Hospital
Baretton, Gustavo Bruno
Germany, Dresden
Universitätsklinikum Carl Gustav Carus Dresden
Tannapfel, Andrea
Germany, Bochum
Ruhr-universitat Bochum
Vieth, Michael
Germany, Erlangen
Friedrich-alexander-universität Erlangen-nürnberg
de Hertogh, Gert
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Verschuere, Stephanie
Belgium, Roeselare
Az Delta
Bergman, Jacques Jghm
Netherlands, Amsterdam
Universiteit Van Amsterdam
Statistics
Citations: 1
Authors: 10
Affiliations: 21
Identifiers
Doi:
10.1053/j.gastro.2023.07.029
ISSN:
00165085
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative
Participants Gender
Male