Morphology-Based Cytosponge Cytology Versus Concurrent Endoscopic Biopsy for Detecting Dysplasia in Barrett's Oesophagus Surveillance: A Prospective, Single-Centre Paired Study.

Authors

Vincent Labador, Cherry Galorport, Hamid Masoudi, Robert Enns, Eric Lam, Neal Shahidi, Pam Wong, Wei Xiong

Published in

Cytopathology : official journal of the British Society for Clinical Cytology. Oct 25, 2026. Epub Oct 25, 2026.

Abstract

Barrett's oesophagus (BE) is the principal precursor of oesophageal adenocarcinoma, and guidelines recommend endoscopic surveillance to detect dysplasia. Endoscopy is invasive and resource-intensive. The Cytosponge is a non-endoscopic cell-collection device. We evaluated Cytosponge cytology against concurrent endoscopic biopsy for detecting dysplasia in a BE surveillance population, and explored factors associated with sample adequacy.
In this prospective, single-centre study, patients with established BE underwent a Cytosponge procedure with a concurrent same-visit endoscopic biopsy. Cytosponge cell blocks were stained with H&E and Alcian Blue 2.5/Periodic Acid-Schiff. Two blinded gastrointestinal pathologists recorded goblet cells and dysplasia by consensus. Sensitivity, specificity, and predictive values with 95% confidence intervals (CI) were calculated against biopsy, and age-adequacy association tested with Fisher's exact test.
Fifty-nine participants were analyzed (median age 70 years; 93.2% male). Cytosponge samples were adequate in 46/59 (78.0%; 95% CI 65.9-86.6). Among 44 adequate paired samples, sensitivity for dysplasia was 76.5% (95% CI 52.7-90.4), specificity 92.6% (76.6-97.9), positive predictive value 86.7%, and negative predictive value 86.2%. Sensitivity for definite (low- plus high-grade) dysplasia was 85.7% (12/14); the lower overall figure reflected indefinite-for-dysplasia cases, of which only one of three was detected. Inadequacy was higher in patients aged ≥ 71 than ≤ 70 years (30% vs. 16%; p = 0.22). No procedural complications occurred.
Cytosponge cytology showed high specificity and moderate sensitivity for dysplasia, with a positive result strongly predicting biopsy-confirmed dysplasia. These pilot data support further evaluation of Cytosponge cytology, reported by trained pathologists, as a non-endoscopic triage tool in BE surveillance.

PMID:
42928614
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.

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