The Tissue Systems Pathology Test Predicts Risk of Progression in Patients With Barrett's Esophagus: Systematic...

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Barrett's esophagus (BE) poses a challenge in identifying patients at risk for progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC).
• The tissue systems pathology (TSP-9) test shows promise in predicting this progression risk in BE patients.

Purpose of the Study:

• To systematically review and meta-analyze clinical validity studies of the TSP-9 test.
• To evaluate the predictive performance of the TSP-9 test for HGD/EAC progression in BE patients.

Main Methods:

• A systematic literature search was performed for clinical validity studies of the TSP-9 test.
• Data on progressors, non-progressors, TSP-9 results, and hazard ratios were extracted for meta-analysis.
• Calculated metrics included odds ratios, sensitivity, specificity, and adjusted predictive values.

Main Results:

• Six studies involving 699 patients were included.
• The TSP-9 test demonstrated significant predictive performance with pooled odds ratios of 6.52 and hazard ratios of 6.66 for progression.
• Key performance metrics included 61% sensitivity, 81% specificity, and a 97% negative predictive value.

Conclusions:

• The TSP-9 test provides effective risk stratification for patients with Barrett's esophagus.
• Results support using the TSP-9 test to guide clinical management, identifying high-risk patients for escalated care and low-risk patients for routine surveillance.