Abedalkarim Rassas, MD, Iva Shkurti, MD, Neepa Patel, MD, Stephen Thai, MS, Jefferson Tran, , Thomas Tran, MD TMC, Denison, TX Introduction: 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 non-dysplastic Barrett's esophagus (NDBE). Our study aimed to evaluate the impact of such platform on the management of NDBE in a rural setting. Methods: This study enrolled all patients diagnosed with NDBE in rural Texas. We utilized the TissueCypher platform (Castle Biosciences, Friendswood, TX), to risk-stratify NDBE cases. All specimens were analyzed using a spatialomics platform which evaluated 9 protein markers: p53, p16, and AMACR (associated with 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-1α 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 all 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 these 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 our previous protocol of 2-3 years. Discussion: The spatialomics platform had a significant impact on the management of NDBE in our study, influencing clinical decision-making in 93% of enrolled patients. Implementation of this technology facilitated timely intervention with eradication therapy for intermediate and high risk patients. Additionally, it led to adjustment of surveillance interval in low-risk patients, optimizing resource utilization and reducing patient burden.
Disclosures: Abedalkarim Rassas indicated no relevant financial relationships. Iva Shkurti indicated no relevant financial relationships. Neepa Patel indicated no relevant financial relationships. Stephen Thai indicated no relevant financial relationships. Jefferson Tran indicated no relevant financial relationships. Thomas Tran indicated no relevant financial relationships.
Abedalkarim Rassas, MD, Iva Shkurti, MD, Neepa Patel, MD, Stephen Thai, MS, Jefferson Tran, , Thomas Tran, MD. P4930 - Impact of Spatialomics Utilization on the Management of Non-Dysplastic Barrett's Esophagus in a Rural Community, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
