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Published in: Current Gastroenterology Reports 12/2021

01-12-2021 | Endoscopy | Esophagus (J Clarke and N Ahuja, Section Editors)

Innovations in Screening Tools for Barrett’s Esophagus and Esophageal Adenocarcinoma

Authors: Matthew G. Bell, Prasad G. Iyer

Published in: Current Gastroenterology Reports | Issue 12/2021

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Abstract

Purpose of Review

Esophageal adenocarcinoma (EAC) is a lethal disease with rapidly rising incidence. Screening for EAC and its metaplastic precursor, Barrett’s esophagus (BE), followed by endoscopic surveillance and endoscopic treatment of dysplasia or early EAC are promising approaches to decreasing EAC incidence and EAC mortality. Historically, screening for EAC has been completed with a traditional per-oral esophagogastroduodenoscopy (EGD); however, this method has limitations including cost, tolerability, and accessibility. For this reason, much effort has been put forward to develop more effective, minimally invasive, and accessible BE and EAC screening tools. The purpose of this review is to describe recent developments of these novel tools.

Recent Findings

While endoscopic alternatives such as transnasal endoscopy are cheaper and well tolerated, they have not gained acceptance. Non-endoscopic modalities namely, swallowable cell collection devices coupled with biomarker analysis have been found to have excellent performance characteristics, tolerability, and cost effectiveness.

Summary

In this article, we provide an update on innovative developments in EAC/BE screening modalities including transnasal endoscopy, capsule endomicroscopy, swallowable cell collection devices, and exhaled volatile organic compound analyses.
Literature
1.
go back to reference Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRef Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRef
2.
go back to reference Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33.CrossRef Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33.CrossRef
3.
go back to reference Njei B, McCarty TR, Birk JW. Trends in esophageal cancer survival in United States adults from 1973 to 2009: A SEER database analysis. J Gastroenterol Hepatol. 2016;31(6):1141–6.CrossRef Njei B, McCarty TR, Birk JW. Trends in esophageal cancer survival in United States adults from 1973 to 2009: A SEER database analysis. J Gastroenterol Hepatol. 2016;31(6):1141–6.CrossRef
4.
go back to reference American Cancer Society Cancer Statistics 2021 Report. J Nucl Med. 2021;62(3):12N. American Cancer Society Cancer Statistics 2021 Report. J Nucl Med. 2021;62(3):12N.
5.
go back to reference Prasad GA, Wu TT, Wigle DA, Buttar NS, Wongkeesong LM, Dunagan KT, et al. Endoscopic and surgical treatment of mucosal (T1a) esophageal adenocarcinoma in Barrett’s esophagus. Gastroenterology. 2009;137(3):815–23.CrossRef Prasad GA, Wu TT, Wigle DA, Buttar NS, Wongkeesong LM, Dunagan KT, et al. Endoscopic and surgical treatment of mucosal (T1a) esophageal adenocarcinoma in Barrett’s esophagus. Gastroenterology. 2009;137(3):815–23.CrossRef
6.
go back to reference Codipilly DC, Chandar AK, Singh S, Wani S, Shaheen NJ, Inadomi JM, et al. The Effect of Endoscopic Surveillance in Patients With Barrett's Esophagus: A Systematic Review and Meta-analysis. Gastroenterology. 2018;154(8):2068–86 e5. Codipilly DC, Chandar AK, Singh S, Wani S, Shaheen NJ, Inadomi JM, et al. The Effect of Endoscopic Surveillance in Patients With Barrett's Esophagus: A Systematic Review and Meta-analysis. Gastroenterology. 2018;154(8):2068–86 e5.
7.
go back to reference Bhat SK, McManus DT, Coleman HG, Johnston BT, Cardwell CR, McMenamin U, et al. Oesophageal adenocarcinoma and prior diagnosis of Barrett’s oesophagus: a population-based study. Gut. 2015;64(1):20–5.CrossRef Bhat SK, McManus DT, Coleman HG, Johnston BT, Cardwell CR, McMenamin U, et al. Oesophageal adenocarcinoma and prior diagnosis of Barrett’s oesophagus: a population-based study. Gut. 2015;64(1):20–5.CrossRef
8.
go back to reference Sami SS, Subramanian V, Ortiz-Fernandez-Sordo J, Saeed A, Singh S, Guha IN, et al. Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract: systematic review and meta-analysis. Gastrointest Endosc. 2015;82(5):782–92.CrossRef Sami SS, Subramanian V, Ortiz-Fernandez-Sordo J, Saeed A, Singh S, Guha IN, et al. Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract: systematic review and meta-analysis. Gastrointest Endosc. 2015;82(5):782–92.CrossRef
9.
go back to reference Peery AF, Hoppo T, Garman KS, Dellon ES, Daugherty N, Bream S, et al. Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video). Gastrointest Endosc. 2012;75(5):945–53 e2. Peery AF, Hoppo T, Garman KS, Dellon ES, Daugherty N, Bream S, et al. Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video). Gastrointest Endosc. 2012;75(5):945–53 e2.
10.
go back to reference Shariff MK, Varghese S, O’Donovan M, Abdullahi Z, Liu X, Fitzgerald RC, et al. Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett’s esophagus. Endoscopy. 2016;48(2):110–6.PubMed Shariff MK, Varghese S, O’Donovan M, Abdullahi Z, Liu X, Fitzgerald RC, et al. Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett’s esophagus. Endoscopy. 2016;48(2):110–6.PubMed
11.
go back to reference Sami SS, Iyer PG, Pophali P, Halland M, di Pietro M, Ortiz-Fernandez-Sordo J, et al. Acceptability, Accuracy, and Safety of Disposable Transnasal Capsule Endoscopy for Barrett's Esophagus Screening. Clin Gastroenterol Hepatol. 2019;17(4):638–46 e1. Sami SS, Iyer PG, Pophali P, Halland M, di Pietro M, Ortiz-Fernandez-Sordo J, et al. Acceptability, Accuracy, and Safety of Disposable Transnasal Capsule Endoscopy for Barrett's Esophagus Screening. Clin Gastroenterol Hepatol. 2019;17(4):638–46 e1.
12.
go back to reference Park J, Cho YK, Kim JH. Current and Future Use of Esophageal Capsule Endoscopy. Clin Endosc. 2018;51(4):317–22.CrossRef Park J, Cho YK, Kim JH. Current and Future Use of Esophageal Capsule Endoscopy. Clin Endosc. 2018;51(4):317–22.CrossRef
13.
go back to reference Bhardwaj A, Hollenbeak CS, Pooran N, Mathew A. A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barrett’s esophagus in patients with gastroesophageal reflux disease. Am J Gastroenterol. 2009;104(6):1533–9.CrossRef Bhardwaj A, Hollenbeak CS, Pooran N, Mathew A. A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barrett’s esophagus in patients with gastroesophageal reflux disease. Am J Gastroenterol. 2009;104(6):1533–9.CrossRef
14.
go back to reference Chen WS, Zhu LH, Li DZ, Chen L, Wu YL, Wang W. String esophageal capsule endoscopy with real-time viewing improves visualization of the distal esophageal Z-line: a prospective, comparative study. Eur J Gastroenterol Hepatol. 2014;26(3):309–12.CrossRef Chen WS, Zhu LH, Li DZ, Chen L, Wu YL, Wang W. String esophageal capsule endoscopy with real-time viewing improves visualization of the distal esophageal Z-line: a prospective, comparative study. Eur J Gastroenterol Hepatol. 2014;26(3):309–12.CrossRef
15.
go back to reference Beg S, Card T, Warburton S, Rahman I, Wilkes E, White J, et al. Diagnosis of Barrett's esophagus and esophageal varices using a magnetically assisted capsule endoscopy system. Gastrointest Endosc. 2020;91(4):773–81 e1. Beg S, Card T, Warburton S, Rahman I, Wilkes E, White J, et al. Diagnosis of Barrett's esophagus and esophageal varices using a magnetically assisted capsule endoscopy system. Gastrointest Endosc. 2020;91(4):773–81 e1.
16.
go back to reference Rubenstein JH, Inadomi JM, Brill JV, Eisen GM. Cost utility of screening for Barrett’s esophagus with esophageal capsule endoscopy versus conventional upper endoscopy. Clin Gastroenterol Hepatol. 2007;5(3):312–8.CrossRef Rubenstein JH, Inadomi JM, Brill JV, Eisen GM. Cost utility of screening for Barrett’s esophagus with esophageal capsule endoscopy versus conventional upper endoscopy. Clin Gastroenterol Hepatol. 2007;5(3):312–8.CrossRef
17.
go back to reference Gora MJ, Sauk JS, Carruth RW, Gallagher KA, Suter MJ, Nishioka NS, et al. Tethered capsule endomicroscopy enables less invasive imaging of gastrointestinal tract microstructure. Nat Med. 2013;19(2):238–40.CrossRef Gora MJ, Sauk JS, Carruth RW, Gallagher KA, Suter MJ, Nishioka NS, et al. Tethered capsule endomicroscopy enables less invasive imaging of gastrointestinal tract microstructure. Nat Med. 2013;19(2):238–40.CrossRef
18.
go back to reference Gora MJ, Queneherve L, Carruth RW, Lu W, Rosenberg M, Sauk JS, et al. Tethered capsule endomicroscopy for microscopic imaging of the esophagus, stomach, and duodenum without sedation in humans (with video). Gastrointest Endosc. 2018;88(5):830–40 e3. Gora MJ, Queneherve L, Carruth RW, Lu W, Rosenberg M, Sauk JS, et al. Tethered capsule endomicroscopy for microscopic imaging of the esophagus, stomach, and duodenum without sedation in humans (with video). Gastrointest Endosc. 2018;88(5):830–40 e3.
19.
go back to reference Gora MJ, Simmons LH, Queneherve L, Grant CN, Carruth RW, Lu W, et al. Tethered capsule endomicroscopy: from bench to bedside at a primary care practice. J Biomed Opt. 2016;21(10):104001. Gora MJ, Simmons LH, Queneherve L, Grant CN, Carruth RW, Lu W, et al. Tethered capsule endomicroscopy: from bench to bedside at a primary care practice. J Biomed Opt. 2016;21(10):104001.
20.
go back to reference Dong J, Grant C, Vuong B, Nishioka N, Gao AH, Beatty M, et al. Feasibility and Safety of Tethered Capsule Endomicroscopy in Patients With Barrett's Esophagus in a Multi-Center Study. Clin Gastroenterol Hepatol. 2021. Dong J, Grant C, Vuong B, Nishioka N, Gao AH, Beatty M, et al. Feasibility and Safety of Tethered Capsule Endomicroscopy in Patients With Barrett's Esophagus in a Multi-Center Study. Clin Gastroenterol Hepatol. 2021.
21.
go back to reference Liang CP, Dong J, Ford T, Reddy R, Hosseiny H, Farrokhi H, et al. Optical coherence tomography-guided laser marking with tethered capsule endomicroscopy in unsedated patients. Biomed Opt Express. 2019;10(3):1207–22.CrossRef Liang CP, Dong J, Ford T, Reddy R, Hosseiny H, Farrokhi H, et al. Optical coherence tomography-guided laser marking with tethered capsule endomicroscopy in unsedated patients. Biomed Opt Express. 2019;10(3):1207–22.CrossRef
22.
go back to reference Januszewicz W, Tan WK, Lehovsky K, Debiram-Beecham I, Nuckcheddy T, Moist S, et al. Safety and Acceptability of Esophageal Cytosponge Cell Collection Device in a Pooled Analysis of Data From Individual Patients. Clin Gastroenterol Hepatol. 2019;17(4):647–56 e1. Januszewicz W, Tan WK, Lehovsky K, Debiram-Beecham I, Nuckcheddy T, Moist S, et al. Safety and Acceptability of Esophageal Cytosponge Cell Collection Device in a Pooled Analysis of Data From Individual Patients. Clin Gastroenterol Hepatol. 2019;17(4):647–56 e1.
23.
go back to reference Kadri SR, Lao-Sirieix P, O'Donovan M, Debiram I, Das M, Blazeby JM, et al. Acceptability and accuracy of a non-endoscopic screening test for Barrett's oesophagus in primary care: cohort study. BMJ. 2010;341:c4372. Kadri SR, Lao-Sirieix P, O'Donovan M, Debiram I, Das M, Blazeby JM, et al. Acceptability and accuracy of a non-endoscopic screening test for Barrett's oesophagus in primary care: cohort study. BMJ. 2010;341:c4372.
24.
go back to reference Ross-Innes CS, Debiram-Beecham I, O'Donovan M, Walker E, Varghese S, Lao-Sirieix P, et al. Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett's esophagus: a multi-center case-control study. PLoS Med. 2015;12(1):e1001780. Ross-Innes CS, Debiram-Beecham I, O'Donovan M, Walker E, Varghese S, Lao-Sirieix P, et al. Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett's esophagus: a multi-center case-control study. PLoS Med. 2015;12(1):e1001780.
25.
go back to reference Chettouh H, Mowforth O, Galeano-Dalmau N, Bezawada N, Ross-Innes C, MacRae S, et al. Methylation panel is a diagnostic biomarker for Barrett’s oesophagus in endoscopic biopsies and non-endoscopic cytology specimens. Gut. 2018;67(11):1942–9.CrossRef Chettouh H, Mowforth O, Galeano-Dalmau N, Bezawada N, Ross-Innes C, MacRae S, et al. Methylation panel is a diagnostic biomarker for Barrett’s oesophagus in endoscopic biopsies and non-endoscopic cytology specimens. Gut. 2018;67(11):1942–9.CrossRef
26.•
go back to reference Fitzgerald RC, di Pietro M, O'Donovan M, Maroni R, Muldrew B, Debiram-Beecham I, et al. 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;396(10247):333–44. This multicenter study utilized the Cytosponge swallowable device coupled with TFF3 analysis specifically in the primary care setting in patients with a diagnosis of GERD. This novel screening modality displayed improved detection of BE in comparison to standard of care. Cytosponge/TFF3 utilization also showed potential for earlier stage diagnosis of both dysplasia and EAC that were more amenable to intervention. Fitzgerald RC, di Pietro M, O'Donovan M, Maroni R, Muldrew B, Debiram-Beecham I, et al. 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;396(10247):333–44. This multicenter study utilized the Cytosponge swallowable device coupled with TFF3 analysis specifically in the primary care setting in patients with a diagnosis of GERD. This novel screening modality displayed improved detection of BE in comparison to standard of care. Cytosponge/TFF3 utilization also showed potential for earlier stage diagnosis of both dysplasia and EAC that were more amenable to intervention.
27.
go back to reference Benaglia T, Sharples LD, Fitzgerald RC, Lyratzopoulos G. Health benefits and cost effectiveness of endoscopic and nonendoscopic cytosponge screening for Barrett's esophagus. Gastroenterology. 2013;144(1):62–73 e6. Benaglia T, Sharples LD, Fitzgerald RC, Lyratzopoulos G. Health benefits and cost effectiveness of endoscopic and nonendoscopic cytosponge screening for Barrett's esophagus. Gastroenterology. 2013;144(1):62–73 e6.
28.
go back to reference Heberle CR, Omidvari AH, Ali A, Kroep S, Kong CY, Inadomi JM, et al. Cost Effectiveness of Screening Patients With Gastroesophageal Reflux Disease for Barrett's Esophagus With a Minimally Invasive Cell Sampling Device. Clin Gastroenterol Hepatol. 2017;15(9):1397–404 e7. Heberle CR, Omidvari AH, Ali A, Kroep S, Kong CY, Inadomi JM, et al. Cost Effectiveness of Screening Patients With Gastroesophageal Reflux Disease for Barrett's Esophagus With a Minimally Invasive Cell Sampling Device. Clin Gastroenterol Hepatol. 2017;15(9):1397–404 e7.
29.
go back to reference Offman J, Muldrew B, O’Donovan M, Debiram-Beecham I, Pesola F, Kaimi I, et al. Barrett’s oESophagus trial 3 (BEST3): study protocol for a randomised controlled trial comparing the Cytosponge-TFF3 test with usual care to facilitate the diagnosis of oesophageal pre-cancer in primary care patients with chronic acid reflux. BMC Cancer. 2018;18(1):784.CrossRef Offman J, Muldrew B, O’Donovan M, Debiram-Beecham I, Pesola F, Kaimi I, et al. Barrett’s oESophagus trial 3 (BEST3): study protocol for a randomised controlled trial comparing the Cytosponge-TFF3 test with usual care to facilitate the diagnosis of oesophageal pre-cancer in primary care patients with chronic acid reflux. BMC Cancer. 2018;18(1):784.CrossRef
30.
go back to reference Iyer PG, Taylor WR, Johnson ML, Lansing RL, Maixner KA, Yab TC, et al. Highly Discriminant Methylated DNA Markers for the Non-endoscopic Detection of Barrett’s Esophagus. Am J Gastroenterol. 2018;113(8):1156–66.CrossRef Iyer PG, Taylor WR, Johnson ML, Lansing RL, Maixner KA, Yab TC, et al. Highly Discriminant Methylated DNA Markers for the Non-endoscopic Detection of Barrett’s Esophagus. Am J Gastroenterol. 2018;113(8):1156–66.CrossRef
31.
go back to reference Kaz AM, Grady WM, Stachler MD, Bass AJ. Genetic and Epigenetic Alterations in Barrett’s Esophagus and Esophageal Adenocarcinoma. Gastroenterol Clin North Am. 2015;44(2):473–89.CrossRef Kaz AM, Grady WM, Stachler MD, Bass AJ. Genetic and Epigenetic Alterations in Barrett’s Esophagus and Esophageal Adenocarcinoma. Gastroenterol Clin North Am. 2015;44(2):473–89.CrossRef
32.
go back to reference Zou H, Molina JR, Harrington JJ, Osborn NK, Klatt KK, Romero Y, et al. Aberrant methylation of secreted frizzled-related protein genes in esophageal adenocarcinoma and Barrett’s esophagus. Int J Cancer. 2005;116(4):584–91.CrossRef Zou H, Molina JR, Harrington JJ, Osborn NK, Klatt KK, Romero Y, et al. Aberrant methylation of secreted frizzled-related protein genes in esophageal adenocarcinoma and Barrett’s esophagus. Int J Cancer. 2005;116(4):584–91.CrossRef
33.
go back to reference Wang Z, Kambhampati S, Cheng Y, Ma K, Simsek C, Tieu AH, et al. Methylation Biomarker Panel Performance in EsophaCap Cytology Samples for Diagnosing Barrett’s Esophagus: A Prospective Validation Study. Clin Cancer Res. 2019;25(7):2127–35.CrossRef Wang Z, Kambhampati S, Cheng Y, Ma K, Simsek C, Tieu AH, et al. Methylation Biomarker Panel Performance in EsophaCap Cytology Samples for Diagnosing Barrett’s Esophagus: A Prospective Validation Study. Clin Cancer Res. 2019;25(7):2127–35.CrossRef
34.•
go back to reference Iyer PG, Taylor WR, Slettedahl SW, Lansing RL, Hemminger LL, Cayer FK, et al. Validation of a methylated DNA marker panel for the nonendoscopic detection of Barrett's esophagus in a multi-site case-control study. Gastrointest Endosc. 2021. This multicenter case-control analysis of the EsophaCap swallowable device coupled with a 5-MDM analysis displayed BE diagnosis sensitivity of 93% and a specificity of 90%. This study shows promising accuracy for utilization of EsophaCap and panel-based MDM analyses for BE detection. Iyer PG, Taylor WR, Slettedahl SW, Lansing RL, Hemminger LL, Cayer FK, et al. Validation of a methylated DNA marker panel for the nonendoscopic detection of Barrett's esophagus in a multi-site case-control study. Gastrointest Endosc. 2021. This multicenter case-control analysis of the EsophaCap swallowable device coupled with a 5-MDM analysis displayed BE diagnosis sensitivity of 93% and a specificity of 90%. This study shows promising accuracy for utilization of EsophaCap and panel-based MDM analyses for BE detection.
35.
go back to reference Iyer PG, Taylor WR, Johnson ML, Lansing RL, Maixner KA, Hemminger LL, et al. Accurate Nonendoscopic Detection of Barrett’s Esophagus by Methylated DNA Markers: A Multisite Case Control Study. Am J Gastroenterol. 2020;115(8):1201–9.CrossRef Iyer PG, Taylor WR, Johnson ML, Lansing RL, Maixner KA, Hemminger LL, et al. Accurate Nonendoscopic Detection of Barrett’s Esophagus by Methylated DNA Markers: A Multisite Case Control Study. Am J Gastroenterol. 2020;115(8):1201–9.CrossRef
36.
go back to reference Moinova HR, LaFramboise T, Lutterbaugh JD, Chandar AK, Dumot J, Faulx A, et al. Identifying DNA methylation biomarkers for non-endoscopic detection of Barrett's esophagus. Sci Transl Med. 2018;10(424). Moinova HR, LaFramboise T, Lutterbaugh JD, Chandar AK, Dumot J, Faulx A, et al. Identifying DNA methylation biomarkers for non-endoscopic detection of Barrett's esophagus. Sci Transl Med. 2018;10(424).
37.
go back to reference Chan DK, Zakko L, Visrodia KH, Leggett CL, Lutzke LS, Clemens MA, et al. Breath Testing for Barrett’s Esophagus Using Exhaled Volatile Organic Compound Profiling With an Electronic Nose Device. Gastroenterology. 2017;152(1):24–6.CrossRef Chan DK, Zakko L, Visrodia KH, Leggett CL, Lutzke LS, Clemens MA, et al. Breath Testing for Barrett’s Esophagus Using Exhaled Volatile Organic Compound Profiling With an Electronic Nose Device. Gastroenterology. 2017;152(1):24–6.CrossRef
38.•
go back to reference Peters Y, Schrauwen RWM, Tan AC, Bogers SK, de Jong B, Siersema PD. Detection of Barrett's oesophagus through exhaled breath using an electronic nose device. Gut. 2020;69(7):1169–72. This proof of concept study utilized a E-nose device to analyze exhaled volatile organic compounds (VOC) of 402 patients (129 with BE, 141 with GERD, and 132 healthy controls). Overall, VOC analysis displayed a BE diagnosis sensitivity of 91% and specificity of 74% and did not show variation based on PPI use, GERD history, or presence/absence of a hiatal hernia. Peters Y, Schrauwen RWM, Tan AC, Bogers SK, de Jong B, Siersema PD. Detection of Barrett's oesophagus through exhaled breath using an electronic nose device. Gut. 2020;69(7):1169–72. This proof of concept study utilized a E-nose device to analyze exhaled volatile organic compounds (VOC) of 402 patients (129 with BE, 141 with GERD, and 132 healthy controls). Overall, VOC analysis displayed a BE diagnosis sensitivity of 91% and specificity of 74% and did not show variation based on PPI use, GERD history, or presence/absence of a hiatal hernia.
39.
go back to reference Zhou Z, Kalatskaya I, Russell D, Marcon N, Cirocco M, Krzyzanowski PM, et al. Combined EsophaCap cytology and MUC2 immunohistochemistry for screening of intestinal metaplasia, dysplasia and carcinoma. Clin Exp Gastroenterol. 2019;12:219–29.CrossRef Zhou Z, Kalatskaya I, Russell D, Marcon N, Cirocco M, Krzyzanowski PM, et al. Combined EsophaCap cytology and MUC2 immunohistochemistry for screening of intestinal metaplasia, dysplasia and carcinoma. Clin Exp Gastroenterol. 2019;12:219–29.CrossRef
Metadata
Title
Innovations in Screening Tools for Barrett’s Esophagus and Esophageal Adenocarcinoma
Authors
Matthew G. Bell
Prasad G. Iyer
Publication date
01-12-2021
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 12/2021
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-021-00821-6

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