دورية أكاديمية
أعرض في EDS

The Tissue Systems Pathology Test Outperforms Pathology Review in Risk Stratifying Patients With Low-Grade Dysplasia.

التفاصيل البيبلوغرافية
العنوان: The Tissue Systems Pathology Test Outperforms Pathology Review in Risk Stratifying Patients With Low-Grade Dysplasia.
المؤلفون: Khoshiwal AM; Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands., Frei NF; Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands., Pouw RE; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands., Smolko C; Castle Biosciences, Inc., Pittsburgh, Pennsylvania., Arora M; Castle Biosciences, Inc., Pittsburgh, Pennsylvania., Siegel JJ; Castle Biosciences, Inc., Pittsburgh, Pennsylvania., Duits LC; Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands., Critchley-Thorne RJ; Castle Biosciences, Inc., Pittsburgh, Pennsylvania. Electronic address: rthorne@castlebiosciences.com., Bergman JJGHM; Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands. Electronic address: j.j.bergman@amsterdamumc.nl.
مؤلفون مشاركون: TissueCypher SURF LGD Study Pathologists Consortium
المصدر: Gastroenterology [Gastroenterology] 2023 Nov; Vol. 165 (5), pp. 1168-1179.e6. Date of Electronic Publication: 2023 Aug 30.
نوع المنشور: Journal Article; Comparative Study; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders Country of Publication: United States NLM ID: 0374630 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-0012 (Electronic) Linking ISSN: 00165085 NLM ISO Abbreviation: Gastroenterology Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : W.B. Saunders
Original Publication: Baltimore.
مواضيع طبية MeSH: Barrett Esophagus*/pathology , Barrett Esophagus*/diagnosis , Esophageal Neoplasms*/pathology , Esophageal Neoplasms*/diagnosis , Disease Progression* , Adenocarcinoma*/pathology , Adenocarcinoma*/diagnosis , Precancerous Conditions*/pathology , Precancerous Conditions*/diagnosis, Humans ; Female ; Middle Aged ; Male ; Risk Assessment ; Aged ; Biopsy ; Observer Variation ; Predictive Value of Tests ; Esophagus/pathology ; Esophagoscopy ; Reproducibility of Results ; Risk Factors
مستخلص: 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.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: Gastroenterology. 2023 Nov;165(5):1106-1107. doi: 10.1053/j.gastro.2023.08.041. (PMID: 37659675)
فهرسة مساهمة: Investigator: J Goldblum, Cleveland Clinic, Cleveland, Ohio.; E Montgomery, University of Miami, Miami, Florida.; J Davison, University of Pittsburgh, Pittsburgh, Pennsylvania.; J Singh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.; J Szymanski, Connect Pathology, Lehi, Utah.; A Perry, Connect Pathology, Lehi, Utah.; K Seldenrijk, St Antonius Hospital, Nieuwegein, The Netherlands.; FT Kate, University Medical Center Utrecht, Utrecht, The Netherlands.; GJA Offerhaus, University Medical Center Utrecht, Utrecht, The Netherlands.; P Drillenberg, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.; C Jansen, Laboratorium Pathologie Oost Nederland, Hengelo, The Netherlands.; N Leeuwis-Fedorovic, Deventer Ziekenhuis, Deventer, The Netherlands.; R Chetty, Deciphex Ltd, Mornington, Ireland, United Kingdom.; R Feakins, Royal Free Hospital, London, United Kingdom.; M Jansen, University College London, London, United Kingdom.; C Chinyama, Princess Elizabeth Hospital, Guernsey, United Kingdom.; E Cooper, Yeovil District Hospital, Somerset, United Kingdom.; R Vaziri, Worcestershire Acute Hospitals, Worcester, United Kingdom.; G Baretton, University Hospital Carl Gustav, Dresden, Germany.; A Tannapfel, Ruhr-Universität Bochum, Bochum, Germany.; M Vieth, Friedrich-Alexander-Universität, Erlangen, Germany.; B Melcher, Institute of Pathology, Koblenz, Germany.; I Mesteri, Institute of Pathology, Überlingen, Germany.; H Müller, Institute of Pathology, Überlingen, Germany.; P Wetzel, Institute of Pathology, Überlingen, Germany.; G de Hertogh, University Hospitals Leuven, Leuven, Belgium.; A Hoorens, UZ Gent, Gent, Belgium.; S Verschuere, AZ Delta, Roeselare, Belgium.; A Tamsin, AZ Delta, Roeselare, Belgium.; K Wetzels, AZ Sint-Blasius, Dendermonde, Belgium.; MV Caillie, AZ Sint-Lucas, Ghent, Belgium.
Keywords: Barrett’s Esophagus; Esophageal Adenocarcinoma; High-Grade Dysplasia; Tissue Systems Pathology test (TSP-9); TissueCypher
SCR Disease Name: Adenocarcinoma Of Esophagus
تواريخ الأحداث: Date Created: 20230901 Date Completed: 20240603 Latest Revision: 20240603
رمز التحديث: 20240604
DOI: 10.1053/j.gastro.2023.07.029
PMID: 37657759
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-0012
DOI:10.1053/j.gastro.2023.07.029