Role of vinegar in identifying abnormal cells in Barrett’s oesophagus
Research type
Research Study
Full title
A feasibility study with a crossover design to assess the diagnostic accuracy of acetic acid targeted biopsies versus non targeted biopsies (current practice) for detection of dysplasia during Barrett’s surveillance: the ABBA study.
IRAS ID
171841
Contact name
Pradeep Bhandari
Contact email
Sponsor organisation
Portsmouth Hospitals NHS Trust
Duration of Study in the UK
2 years, 7 months, 1 days
Research summary
Adenocarcinoma, a type of oesophageal (gullet) cancer, is the 5th commonest UK cancer. By the time patients have symptoms, the cancer is often incurable. People with Barrett’s oesophagus (changes in the oesophagus lining) are at risk of developing this cancer but can have regular check-ups to detect changes before they progress. Every two years patients with Barrett's are offered examination by passing a fibre-optic tube into the oesophagus (gastroscopy) to remove small tissue samples (biopsies) which are examined in the laboratory to check for changes. However, the doctor cannot tell during gastroscopy where cells are changing so many protocol guided biopsies are taken but pre-cancerous cells may be missed.
A new technique detects pre-cancerous cells in some patients using acetic acid (vinegar) during gastroscopy. The acetic acid is not harmful, and is sprayed thinly onto the oesophagus lining. Areas likely to have cell changes appear red, so the doctor can take targeted biopsies, rather than sampling by a pre-defined protocol. This reduces the time needed for gastroscopy and number of biopsies. We wish to investigate whether this can better detect precancerous cells in patients having two-yearly gastroscopies.
Before undertaking a full-scale study, we need to test whether the study is suitably designed. A sample of patients in different hospitals will be invited to participate in a feasibility study. Participants will have two gastroscopies 4-10 weeks apart – one using mapping biopsies (current practice) and one using acetic acid. We will monitor how many agree to participate and reasons for withdrawal from the study. Numbers of precancerous areas detected by each method will inform how many patients we need for a larger study to test which method is best. We will explore participants’ and doctors’ views about acceptability of the new technique and how to improve study procedures using telephone interviews.
REC name
South Central - Hampshire B Research Ethics Committee
REC reference
15/SC/0085
Date of REC Opinion
11 Mar 2015
REC opinion
Favourable Opinion