{
  "abstract": "Background Barrett’s esophagus (BE) increases the risk of developing esophageal adenocarcinoma. Over 90% of BE cases are non-dysplastic BE (NDBE). Spatialomics is an emerging technology that analyzes biological molecules in their natural tissue environment. We utilized a spatialomics-based computational platform that analyzes multiple biomarkers and tissue morphology features to provide an objective risk stratification for NDBE. Our study evaluated the impact of this platform on the management of NDBE in rural Texas.Methods This study enrolled NDBE patients in rural Texas. We utilized the TissueCypher platform (Castle Biosciences, Friendswood, TX). Specimens were analyzed using a spatialomics platform, which evaluated 9 protein markers: p53, p16, and AMACR (loss of tumor suppression and cell cycle dysregulation); CD68 and COX-2 (immune and inflammatory markers); HER-2 and CK20 (cancer growth and cellular transformation); and HIF-1 α and CD45RO (angiogenesis and memory lymphocyte infiltration) and 7 key tissue characteristics: stroma, cells, epithelium, epithelial nuclei, nuclei, cytoplasm, and metaplastic epithelium. A risk stratification scoring system was utilized: low (score 0–5.4), intermediate (score 5.5–6.4), and high (score 6.5–10).Results A total of 114 patients were diagnosed with NDBE from January 2023 to November 2024. Of these, 62 (54.4%) were female, and 52 (45.6%) were male, with a mean age of 65.5 years (SD 13.3, range 31–92 years). The mean BE segment length was 2.8 cm (SD 2.6 cm, range 0.3–18 cm). Spatialomics tests were performed on 114 patients, though 8 specimens were ‘unreportable’ due to insufficient tissues. Of the 106 reportable cases, the mean score was 2.5 (SD 1.7, range 0–7.8). The 5-year progression probability had a mean of 2.0% (SD 3.3, range 0.2–25%). Risk stratification identified 5 patients as intermediate risk and 2 as high risk; all 7 patients underwent radiofrequency ablation, resulting in complete eradiation of BE. The remaining 99 patients were downgraded to a surveillance interval of 5 years from 2-3 years previously.Conclusions TissueCypher had a significant impact on the management of NDBE, influencing clinical decision-making in 93% of patients. Its implementation facilitated timely intervention with eradication therapy for intermediate and high-risk patients. Additionally, it led to the adjustment of surveillance in low-risk patients, optimizing resource utilization.",
  "authors": [
    {
      "affiliations": [
        "Texoma Medical Center, United States"
      ],
      "name": "Jefferson Tran"
    },
    {
      "affiliations": [
        "Texoma Medical Center, United States"
      ],
      "name": "Abedalkarim Rassas"
    },
    {
      "affiliations": [
        "Texoma Medical Center, United States"
      ],
      "name": "Iva Shkurti"
    },
    {
      "affiliations": [
        "Texoma Medical Center, United States"
      ],
      "name": "Neepa Patel"
    },
    {
      "affiliations": [
        "Texoma Medical Center, United States"
      ],
      "name": "Stephen Thai"
    }
  ],
  "title": "IDDF2026-ABS-0412 Application of a tissue biomarker to risk-stratify barrett’s esophagus in rural texas",
  "uid": "bfb9eac0-0ef4-5cc8-83a7-24b67ad09d30"
}