Wide-area transepithelial sampling for dysplasia detection in Barrett’s esophagus: a systematic review and meta-analysis - 09/12/21
Abstract |
Background and Aims |
Seattle protocol forceps biopsy sampling (FB) is currently recommended for surveillance in Barrett’s esophagus (BE) but limited by sampling error and lack of compliance. Wide-area transepithelial sampling with 3-dimensional analysis (WATS3D; CDx Diagnostics, Suffern, NY, USA) is reported to increase BE dysplasia detection. We assessed the incremental yield and clinical significance of WATS3D for dysplasia detection over FB in a systematic review and meta-analysis.
Methods |
We queried major scientific databases for studies using WATS3D and FB from 2000 to 2020. The primary outcome was the incremental yield of WATS3D-detected dysplasia (defined as a composite of indefinite for dysplasia, low- and high-grade dysplasia [HGD] and esophageal adenocarcinoma [EAC]) over FB. Secondary outcomes were incremental yields of HGD/EAC and rate of reconfirmation of WATS3D dysplasia on subsequent FB.
Results |
Meta-analysis of 7 eligible studies demonstrated that FB diagnosed dysplasia in 15.9% of cases, whereas the incremental yield with WATS3D was 7.2% (95% confidence interval, 3.9%-11.5%; I2 = 92.1%). Meta-analysis of 6 studies demonstrated that FB diagnosed HGD/EAC in 2.3% of patients, whereas the incremental yield with WATS3D was 2.1% (95% confidence interval, .4%-5.3%; I2 = 92.7%). Notably, WATS3D was negative in 62.5% of cases where FB identified dysplasia. Two studies reported reconfirmation of WATS3D dysplasia with FB histology in only 20 patients.
Conclusions |
WATS3D increases dysplasia detection; however, the clinical significance of this increased dysplasia detection remains uncertain. Data from endoscopic follow-up to ascertain FB histology in patients with dysplasia based solely on WATS3D are needed to determine the optimal clinical application and significance of WATS3D-only dysplasia.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : BE, DBE, EAC, FB, HGD, IND, LGD, WATS3D
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| DISCLOSURE: The following authors received research support for this study from the National Institutes of Health: P. N. Thota (CA150964, CA163060), A. Chak (CA150964, CA163060), P. G. Iyer (CA163060, CA 241164). In addition, the following authors disclosed financial relationships: K. K. Wang: Research funding from Fuji Medical and Erbe. D. A. Katzka: Research funding from Shire. J. R. Goldblum: Consultant for Lucid Diagnostics, Interpace, Cernostics, and CDx. G. W. Falk: Research funding from Lucid and Interpace; consultant for Lucid, Interpace, Cernostics, and CDx. A. Chak: Consultant for and equity in Lucid Diagnostics. P. G. Iyer: Research funding from Exact Sciences and Pentax Medical; consultant for Medtronic P. N. Thota, research funding from Interpace. All other authors disclosed no financial relationships. |
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| DIVERSITY, EQUITY, AND INCLUSION: One or more of the authors of this paper self-identifies as an under-represented gender minority in science. While citing references scientifically relevant for this work, we actively worked to promote gender balance in our reference list. |
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| If you would like to chat with an author of this article, you may contact Dr Iyer at iyer.prasad@mayo.edu. |
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| See CME section, p. 171. |
Vol 95 - N° 1
P. 51 - gennaio 2022 Ritorno al numero
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