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Review
. 2017 Jul;27(3):379-396.
doi: 10.1016/j.giec.2017.02.002. Epub 2017 Apr 4.

Alternatives to Traditional Per-Oral Endoscopy for Screening

Judith Offman  1 , Rebecca C Fitzgerald  2
Affiliations
Review

Alternatives to Traditional Per-Oral Endoscopy for Screening

Judith Offman et al. Gastrointest Endosc Clin N Am. 2017 Jul.

Abstract

Barrett's esophagus (BE) predisposes patients to esophageal adenocarcinoma. 3 to 6% of individuals with gastro-esophageal reflux disease are estimated to have BE but only 20 to 25% of BE patients are currently diagnosed. The current gold standard for diagnosis of BE is per-oral upper GI endoscopy. As this is not suitable for large-scale screening, a number of alternative methods are currently being investigated: transnasal and video capsule endoscopy, endomicroscopy, cell collection devices like the cytosponge and biomarkers. Some of these are promising, however, well powered studies carried out in relevant screening populations are needed.

Keywords: Barrett’s esophagus; Biomarkers; Cell collection; Endoscopy; Esophageal adenocarcinoma; Screening; Transnasal endoscopy; Video capsule endoscopy.

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Conflict of interest statement

Conflicts of interest

The authors disclose the following: R.C.F. holds patents on the Cytosponge technology, which has been licensed by MRC Technology to Covidien GI Solutions (now Medtronic). R.C.F. has no direct financial arrangement with Metronic. J.O. has no conflict of interest to declare.

Figures

Fig. 1
Fig. 1. Endoscopic diagnosis of Barrett’s esophagus with conventional per-oral and office-based transnasal endoscopy.
(A) High resolution white light endoscopy. Barrett’s esophagus appears as salmon red coloured mucosa and normal oesophagus in pale pink. (B) Transnasal EG scan endoscopic view of a short segment of Barrett’s esophagus. (C) Transnasal endosheath endoscopic diagnosis of Barrett’s. This technology also allows biopsies for histological confirmation.
Fig. 2
Fig. 2. Use of the Cytosponge™ test.
(A) Expanded Cytosponge (left) and Cytosponge embedded in gelatine capsule (right). (B) The Cytosponge compared to paracetamol capsules in the palm of a hand. (C) The Cytosponge is swallowed and the gelatin capsule dissolves in the stomach within 5 minutes. (D) The Cytosponge is retrieved by a nurse collecting cells as it is pulled up. (E) Immunohistochemical images (20x magnification) illustrating TFF3-positive staining in cells collected with the Cytosponge.
See this image and copyright information in PMC

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