In the Journals

Cytosponge safe, well-tolerated, accurate tissue collection method vs. endoscopy for EoE evaluation

When compared with endoscopy for tissue sample collection for assessment of eosinophilic esophagitis, Cytosponge demonstrated comparable safety and accuracy, and was the preferred method in all patients, according to new research data.

David A. Katzka, MD

David A. Katzka

Aiming to evaluate the device’s accuracy, safety and tolerability compared with standard endoscopy and esophageal biopsy for assessment of eosinophilic esophagitis (EoE), David A. Katzka, MD, from the Mayo Clinic, and colleagues collected esophageal tissue samples from 20 patients aged 22 to 51 years with EoE (all with dysphagia, 15 with stricture, 13 with active EoE), first using Cytosponge then by endoscopy.

All Cytosponge samples were adequate for analysis, and there was good correlation between eosinophil numbers with Cytosponge compared with histology (P=.025). Using at least 15 eosinophils/high-power field as a positive definition for active EoE, Cytosponge identified 11 of 13 patients with active EoE with 84.6% sensitivity. Additional features such as abscesses were also identified. Cytosponge also identified four of the seven patients without active EoE with 57% specificity, as well as three cases of active EoE not identified by analysis of endoscopy samples. Inclusion of information related to eosinophil-derived neurotoxin levels did not increase diagnostic accuracy. No complications occurred with Cytosponge, and 100% of patients preferred Cytosponge over endoscopy.

“This pilot study shows the Cytosponge to be a safe, easy to perform, inexpensive, and accurate test to monitor patients with EoE without the need for endoscopy and biopsy, but larger multicenter studies are needed to confirm its efficacy,” Katzka told Healio Gastroenterology.

Disclosure: Two of the researchers developed the Cytosponge, which is licensed by MRC-Technology to Covidien GI Solutions. The device used in the study was a research prototype developed by the Medical Research Council, UK. Another researcher is an employee of Covidien.

When compared with endoscopy for tissue sample collection for assessment of eosinophilic esophagitis, Cytosponge demonstrated comparable safety and accuracy, and was the preferred method in all patients, according to new research data.

The Cytosponge (Covidien), recently developed for less invasive Barrett’s esophagus and esophageal cancer screening, is an ingestible gelatin capsule containing compressed mesh attached to a string. Once swallowed, the gelatin dissolves in the stomach, releasing the spherical mesh, which collects the tissue specimen when withdrawn.

David A. Katzka, MD

David A. Katzka

Aiming to evaluate the device’s accuracy, safety and tolerability compared with standard endoscopy and esophageal biopsy for assessment of eosinophilic esophagitis (EoE), David A. Katzka, MD, from the Mayo Clinic, and colleagues collected esophageal tissue samples from 20 patients aged 22 to 51 years with EoE (all with dysphagia, 15 with stricture, 13 with active EoE), first using Cytosponge then by endoscopy.

All Cytosponge samples were adequate for analysis, and there was good correlation between eosinophil numbers with Cytosponge compared with histology (P=.025). Using at least 15 eosinophils/high-power field as a positive definition for active EoE, Cytosponge identified 11 of 13 patients with active EoE with 84.6% sensitivity. Additional features such as abscesses were also identified. Cytosponge also identified four of the seven patients without active EoE with 57% specificity, as well as three cases of active EoE not identified by analysis of endoscopy samples. Inclusion of information related to eosinophil-derived neurotoxin levels did not increase diagnostic accuracy. No complications occurred with Cytosponge, and 100% of patients preferred Cytosponge over endoscopy.

“This pilot study shows the Cytosponge to be a safe, easy to perform, inexpensive, and accurate test to monitor patients with EoE without the need for endoscopy and biopsy, but larger multicenter studies are needed to confirm its efficacy,” Katzka told Healio Gastroenterology.

Disclosure: Two of the researchers developed the Cytosponge, which is licensed by MRC-Technology to Covidien GI Solutions. The device used in the study was a research prototype developed by the Medical Research Council, UK. Another researcher is an employee of Covidien.