O198: Cytosponge: Innovative technology in Barrett’s oesophagus surveillance

Abstract

Abstract Introduction British Society of Gastroenterology guidance recommends oesophagogastroduodenoscopy (OGD) for Barrett’s oesophagus surveillance with quandrantic biopsies for every 2cm length of Barrett’s. The Covid pandemic led to delays in Barrett's surveillance and prolongation of surveillance intervals. This study assessed the potential role of Cytosponge, a novel cytology sampling device, in Barrett's surveillance. Methodology All patients due Barrett's surveillance in 2022/23 were identified and screened to assess suitability for Cytosponge. Cytology results and associated early clinical outcomes were assessed. Results 193 patients (77%) were suitable for Cytosponge, and 175 of these (90%) did not require OGD. 18 patients (10%) required urgent OGD for inadequate cytology samples (3), cellular atypia (8), aberrant p53 (3) or dysplasia (4). 2 patients had high grade dysplasia on subsequent OGD, successfully treated with radiofrequency ablation. No diagnosis of oesophago-gastric cancer was made during the follow-up period. By July 2023, 282 patients with Barrett’s oesophagus had completed Cytosponge assessment; minimum follow-up was 4 months and no patients had developed ‘inter-test’ malignancy. Conclusion These data are promising and suggest that endoscopy and biopsy may not be required for all Barrett’s surveillance. Cytology samples alone may be sufficient to assess for epithelial dysplastic and neoplastic change in Barrett’s surveillance, with judicious utilisation of endoscopy resources where indicated and necessary. Patients who received a Cytosponge in 2022 will be due for endoscopic surveillance in 2024 – these data will provide valuable additional information about the role of Cytosponge in Barrett’s surveillance and whether endoscopy can be replaced altogether.