TFF3 is a promising biomarker for screening for Barrett’s oesophagus

Economical ways of making an early diagnosis of Barrett’s oesophagus are essential if population screening is to be possible. The study by Lao-Sirieix and colleagues describes the use of a polyurethane sponge contained within a gelatine capsule attached to a string that is swallowed and retrieved after 3–5 minutes. Cells caught in the sponge are pelleted and processed immunohistochemically. Twenty-four candidate genes of possible biomarkers upregulated in Barrett’s oesophagus were identified from a review of published microarrays. Of these, dopa decarboxylase (DDC) and trefoil factor 3 (TFF3)were confirmed by real-time polymerase chain reaction to be over-expressed in oesophageal but not gastric biopsies from five patients with Barrett’s oesophagus and five healthy controls. Over-expression of TFF3 but not DDC was confirmed immunohistochemically in the oesophagus but not stomach of 21 patients with Barrett’s oesophagus and 20 controls (see fig). TFF3 was tested with the sponge capsule in 46 patients with >3 cm of Barrett’s oesophagus and 99 controls. Positive staining was seen in 36/46 patients and 6/99 controls, giving a sensitivity of 78%, specificity of 94% and a likelihood ratio of 13. This good performance could be enhanced in the future by DNA based assessment—such as methylation status or loss of heterozygosity—which could indicate the risk of progression to cancer.

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Wireless capsule endoscopy is feasible and safe in young children

Wireless capsule endoscopy (WCE) has been widely used in adults but experience of its use in small children is limited. This European multicentre report describes 83 children <8 years …