The following is a summary of “An Automated Tissue Systems Pathology Test Can Standardize the Management and Improve Health Outcomes for Patients With Barrett’s Esophagus,” published in the November 2023 issue of Gastroenterology by Duits, et al.
Low-grade dysplasia (LGD) in Barrett’s esophagus (BE) poses an elevated risk of progressing to high-grade dysplasia or esophageal adenocarcinoma. However, the management of LGD is complicated by significant interobserver variability in pathology diagnoses. For a study, researchers sought to assess the efficacy of a tissue systems pathology test (TissueCypher, TSP-9) in objectively stratifying risk for BE patients, aiming to standardize management decisions and improve health outcomes.
A cohort of 154 BE patients with community-based LGD from the SURF trial underwent evaluation. Generalist (n = 16) and expert (n = 14) pathology reviewers iterated 500 simulated management decisions. The study compared care plans determined by pathology alone, pathology with TSP-9 guidance, and TSP-9 results alone. The appropriateness of management decisions was calculated based on known progression/nonprogression outcomes.
The use of TSP-9 results, independently or in conjunction with pathology, significantly increased the percentage of patients receiving appropriate management. Specifically, the rate increased from 9.1% with pathology alone to 58.4% with pathology and TSP-9 guidance, reaching 77.3% when relying solely on TSP-9 results. Additionally, TSP-9 utilization enhanced the consistency of management decisions across different pathologists’ evaluations (P < 0.0001).
Implementing the TSP-9 test in management decisions demonstrated the potential to standardize care plans. It enhanced the early detection of progressors eligible for interventions and increased the proportion of nonprogressors avoiding unnecessary therapy, thereby enabling surveillance-based management.
Source: journals.lww.com/ajg/fulltext/2023/11000/an_automated_tissue_systems_pathology_test_can.24.aspx
