Barrett Esophagus, Barretts Esophagus With Dysplasia, Oesophageal Cancer
Conditions
Keywords
Oesophageal Cancer, Barretts Esophagus with Dysplasia
Brief summary
This study aims to determine whether a breath test could be used for early detection of oesophageal cancer and Barrett's high grade dysplasia. Patients who are attending for a planned gastroscopy or who are scheduled to undergo elective resection of histologically confirmed early stage oesophageal adenocarcinoma or dysplasia will be approached to provide a breath sample. Multi platform mass spectrometry analysis will be performed to establish volatile biomarkers that can discriminate between early stage (T1) oesophageal cancer/ Hight grade dysplasia from non cancer healthy controls/non dysplastic Barrett's cancer.
Detailed description
The incidence of oesophageal adenocarcinoma has been rising over the last decade. Despite improvements in oncological and surgical therapies the associated survival remains poor, mainly due to delays in diagnosis and advanced stage at presentation. Identifying patients at earlier stages as well as those at risk of cancer may lead to survival benefit. Barrett's oesophagus is an established risk factor for the development of oesophageal adenocarcinoma. It has an established histopathologic progression from low-grade, through high-grade dysplasia (HGD) to oesophageal adenocarcinoma (OAC). Barrett's oesophagus patients currently undergo regular endoscopic surveillance to allow earlier detection of oesophageal cancer. The primary objective is to evaluate the diagnostic accuracy and clinical utility of the volatile organic compounds (VOC) in exhaled breath to detect early stage oesophageal adenocarcinoma and high-grade dysplastic Barrett's oesophagus. All patients will be fasted for a minimum of 6 hours prior to the breath sample as part of their routine clinical care. Breath collection will be conducted using a previously validated method. Samples of breath (500ml) collected using breath collecting device utilising bags. Breath samples collected within thermal desorption tubes (Markes International, Llantrisant, UK) will be transferred to a central laboratory for analysis by gas chromatography mass spectrometry (GC-MS) and proton transfer reaction time of flight mass spectrometry (PTR-ToF-MS). Raw data files will be extracted and analysed in accordance with established protocols.
Interventions
DIAGNOSTIC_TESTBreath test
Patients will provide a breath test prior to gastroscopy or resection of Barrett's HGD lesion or oesophageal cancer.
Sponsors
Guts UK
University College London Hospitals
Guy's and St Thomas' NHS Foundation Trust
Oxford University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
University Hospital Birmingham NHS Foundation Trust
Northern Care Alliance NHS Foundation Trust
London North West Healthcare NHS Trust
Imperial College London
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* ≥18 years and ≤90 years of age * Undergoing gastroscopy or elective resection of histologically confirmed oesophageal adenocarcinoma/ high grade dysplasia * Fasted \>6 hours * Able to provide informed written consent
Exclusion criteria
* Any patient \<18 years or \>90 years of age. * Lacks capacity or is unable to provide informed written consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determine the diagnostic accuracy of breath test for detection of early oesophageal cancer and Barrett's high grade dysplasia | 4 years | Diagnostic accuracy will be measured by calculating the sensitivity and specificity of the test for detection of early oesophageal cancer/ high grade dysplasia. Sensitivity and specificity values are represented by a number between 0 to 1 indicating the test's ability to pick up true positive results and true negative results respectively, where a number closer to one indicates a greater detection ability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic validation study of the breath profile for prediction of early oeosphageal cancer and high grade dysplasia | 3 | After diagnostic accuracy has been determined as per objective 1 by the discovery phase of the proposed study, a validation phase will then follow to confirm findings. Diagnostic accuracy of the validation phase results will be measured by calculating the sensitivity and specificity of the test for detection of T1 oesophageal cancer and dysplasia. Sensitivity and specificity values are represented by a number between 0 to 1 indicating the test's ability to pick up true positive results and true negative results respectively, where a number closer to one indicates a greater detection ability. |
Countries
United Kingdom
Contacts
Primary ContactSara H Jamel, MBBS MRCS
Backup ContactGeorge B Hanna, FRCS PhD
Outcome results
None listed