‘Pill on a string’ Can Identify Oesophageal (Gullet) Cancer: New Study

Researchers from the University of Cambridge have found a new method that will help the doctors to identify oesophageal cancer (gullet cancer) easily.

Barrett’s oesophagus – a state where cells within the oesophagus lining starts to change shape and grow unusually, is often the starting point of oesophageal cancer, which a type of cancer that can be hard to treat if not caught early.

The ‘Cytosponge’ is present within a pill that when gulped down, dissolved to divulge a sponge that eliminates cells when removed from the oesophagus. This permits doctors to assemble cells from all along the food pipe, while normal biopsies consider individual point models.


Photo Credit: YouTube screen shot of Cytosponge by University of Cambridge

Currently, Barrett’s oesophagus and oesophageal cancer are detected with the help of biopsies that search for indications of dysplasia – the spread of unusual cancer cells. However, learning how oesophageal cancer fosters and the eventual genetic mutations that are engaged with it, doctors around the globe will easily be able to identify the disease in its earlier stage.

An alternate of detecting early indications of oesophageal cancer would be to search for significant genetic alterations. But, researchers from Cambridge have shown that disparities in mutations around the oesophagus meant that normal biopsies may skip cells with significant mutations.

On the other hand, a model has more possibility to pick up chief mutations in the cells if ‘cytosponge’ was utilized, which is fostered by Rebecca Fitzgerald at the Medical Research Council Cancer Unit in Cambridge.

Fitzgerald said that the issue with “Barrett’s oesophagus is that it looks bland and might span over 10cm.” She explained that for the research she and her team made a “map of mutations in a patient with the condition” and discovered that within the 10cm section, a lot of variation amongst the cells is present.


Photo Credit: YouTube screen shot of Rebecca Fitzgerarld by University of Cambridge

“Some might carry an important mutation, but many will not. If you’re taking a biopsy, this relies on your hitting the right spot. Using the Cytosponge appears to remove some of this game of chance,” she added.

Fitzgerald and her team performed a complete genome sequencing to evaluate paired Barrett’s oesophagus and oesophageal cancer models obtained at a particular time from 23 patients, and 73 models obtained from only one patient, having Barrett’s oesophagus over duration of three-years.

They discovered patterns of mutations in the genome, which is a “fingerprint” of the reasons for developing cancer. Like previous studies that showed that cigarettes leave fingerprints in a person’s DNA, through this study the team discovered fingerprints that they believe are possibly due to the damage that stomach acid caused to the lining of the oesophagus by splashing onto the latter’s walls.

They noticed the same fingerprints in Barrett’s oesophagus as well as oesophageal cancer, recommending that such alterations happen at very early stages.

Not only this, in the areas where only Barrett’s oesophagus minus cancer was detected, the research team discovered that a large number of mutations that averagely counted up to 12,000 per individual compared to 18,000 mutations within “cancer”.

Majority of these could have ‘bystanders’ who suffered genetic mutations, but were not really associated with cancer.

Dr. Caryn Ross-Innes who is the co-author of the study said that very little is known about how one goes from pre-cancer to cancer, and this is specifically how oesophageal cancer works.

“Barrett’s oesophagus and the cancer share many mutations, but we are now a step closer to understanding which are the important mutations that tip the condition over into a potentially deadly form of cancer,” she added.

The research has been published in the journal Nature Genetics.

According to World Cancer Research Fun International, 456,000 new cases of oesophageal cancer were reported worldwide in 2012 and it was the eighth most cancer type to occur in patients. The Cancer Research UK said 7,701 individuals lost their lives to oesophageal cancer in 2012 in U.K. alone.

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