P1343 - Using TissueCypher to Detect the Progression of Neoplasia in Barrett’s Esophagus - A Literature Review

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Henry Klos, MD

University at Buffalo Internal Medicine
Buffalo, NY, United States

Henry Klos, MD¹, Sultan Mahmood, MD², Muhammad Tahir, MD²
¹University at Buffalo Internal Medicine, Buffalo, NY; ²University at Buffalo Gastroenterology, Buffalo, NY

Introduction: Dysplasia screening in Barrett's esophagus is costly, and currently, there is no clear way to predict the disease progression. TissueCypher is a test composed of several genetic markers, aimed at estimating progression as a way to label patients with a specific risk progression score, so that they may be targeted to the most appropriate screening interval. Risk scores are calculated on a scale of 0-10 and grouped into either low, intermediate, or high risk. This is currently an emerging method that attempts to minimize costs associated with Barrett’s screening and help identify which subset of patients are at high risk for progressing to adenocarcinoma.

Methods: 7 studies were included in the total. Data from the articles were analyzed, and weight averages were calculated based on available information. The total population size was 1080. 39.12% (340/869) patients had a short segment, while 56.27% (490/869) patients had long-segment Barrett’s esophagus ( >4cm). See image-1 below for further demographic data.

The initial grade of dysplasia was reported in 1063 patients: ND was found in 70.93% (754/1063), IND in 0.08% (87/1063), LGD in 0.19% (205/1063) and HGD in 0.015% (17/1063).

Results: The risk class was reported in 886 patients. There were 71.78% (636/886) patients in low risk, 13.09% (116/886) in intermediate and 15.12% (134/886) in high-risk class. Only one study reported an average TissueCypher score of 4.95 in 17 patients which is classified as low risk (0-5.5).

We calculated weighted averages of TissueCypher’s 5-year progression prediction for 598 patients. The average NPV reported was 95.85%, with a PPV of 26.93%, with one study reporting 10-year values of NPV and PPV, which were 88.2% and 56.9% respectively.

Weighted averages for the following were calculated in both high vs low risk, and intermediate vs low risk categories. Values were respectfully as follows: Hazard Ratio 6.51, 1.87; Odds Ratio 6.15, 5.94. The AUROC was calculated as 0.848 for 5-year high vs non-risk. 5-year, and 10-year sensitivity and specificity were also calculated. Tables 1 demonstrates these values.

Discussion: TissueCypher is an emerging test to improve the risk stratification of patients with Barrett's esophagus. With further research, given high NPV, TissueCypher could potentially offer cost-effective management for low-risk patients, while giving us a better understanding of which patients are at high risk for progression.

Figure: Figure 1: Demographics and population characteristics

Table 1	5 - Year	10 - Year
Negative Predictive Value	0.9585	0.882
Positive Predictive Value	0.2693	0.569
Sensitivity	0.432	0.664
Specificity	0.833	0.85

Table: Table 1: Weighted averages of TissueCypher tests.

Disclosures:

Henry Klos indicated no relevant financial relationships.

Sultan Mahmood indicated no relevant financial relationships.

Muhammad Tahir indicated no relevant financial relationships.

Henry Klos, MD¹, Sultan Mahmood, MD², Muhammad Tahir, MD². P1343 - Using TissueCypher to Detect the Progression of Neoplasia in Barrett’s Esophagus - A Literature Review, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.