Role of TFF3 as an adjunct in the diagnosis of Barrett's esophagus using a minimally invasive esophageal sampling device—The Cytosponge^TM

Abstract

The incidence of esophageal carcinoma continues to increase whilst its prognosis remains poor. The most dramatic reduction in mortality is likely to follow early diagnosis of the preinvasive precursor lesion, Barrett's esophagus (BE), coupled with treatment of dysplastic lesions. The major risk factor for BE is gastroesophageal

Cytosponge-trefoil factor 3 versus usual care to identify Barrett's oesophagus in a primary care setting: a multicentre, pragmatic, randomised controlled trial

“…Samples collected from the Cytosponge procedure were processed centrally and assessed for the presence of Barrett's oesophagus by use of haematoxylin and eosin staining and immunohistochemical staining for TFF3 (Ventana Medical Systems, Tuscon, AZ, USA), as described previously. 20 TFF3 staining was evaluated by experienced upper gastrointestinal pathologists, and consensus agreement from two or three pathologists was used in any cases of uncertainty. A sample in which no glandular cells were present was deemed to provide a low-confidence result, as the device might not have reached the stomach and a diagnosis of distal Barrett's oesophagus might have therefore been missed.…”

“…We have developed a test for Barrett's oesophagus that is suitable for use in the primary care setting. The test comprises a non-endoscopic cell collection device coupled with an in vitro test for the specific biomarker, trefoil factor 3 (TFF3), that identifies intestinal metaplasia (the histopathological hallmark of Barrett's oesophagus; 20 figure 1 ). Thus far, two clinical studies 21 , 22 of this new clinical strategy, termed the Cytosponge-TFF3 procedure, have been done in over 2000 patients, with promising data on safety, acceptability, accuracy, and cost-effectiveness.…”

Minimally invasive esophageal sponge cytology sampling is feasible in a Tanzanian community setting

“…One week training in sample processing and cytopathology review was delivered by a biomedical scientist (MB) and histopathologist (MOD). Cytosponge samples were processed into formalin‐fixed paraffin embedded (FFPE) blocks by adapting an SOP 18 . Agarose gel (Sigma‐Aldrich) was substituted for plasma‐thrombin and stirred into the centrifuged cell pellets to form a clot.…”

“…Cytosponge samples were processed into formalin-fixed paraffin embedded (FFPE) blocks by adapting an SOP. 18 Agarose gel (Sigma-Aldrich) was substituted for plasma-thrombin and stirred into the centrifuged cell pellets to form a clot. Blocks were transported to IARC where slides were prepared by cutting two serial sections from each block and staining with hematoxylin and eosin (H&E).…”

Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic

“…Cytosponge 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). 3 , 4 The safety, acceptability, and diagnostic accuracy of this approach has been assessed in three clinical trials, including the recent BEST3 trial. 5 , 6 , 7 In light of COVID-19 restrictions, we assessed whether Cytosponge could triage patients referred for urgent investigation of alarm oesophageal symptoms.…”