ReviewGastro hep advances2026
Systematic Review and Meta-Analysis of TissueCypher and p53 Immunohistochemistry for Risk Stratification in Barrett's Esophagus.
Review in Gastro hep advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Barrett's esophagus surveillance relies on subjective biopsy grading that misses fast progressors. Although the Tissue Systems Pathology-9 (TSP-9) test and p53 immunohistochemistry (IHC) have each been evaluated separately, no prior study has directly compared the 2 within a single analytic framework. We compared both biomarkers for predicting progression to high-grade dysplasia or esophageal adenocarcinoma. Methods: PubMed, Embase, Cochrane, and Web of Science were searched through December 2025. Studies were included if they evaluated TSP-9 or p53 IHC in patients with non-dysplastic Barrett's esophagus, indefinite for dysplasia, or low-grade dysplasia and reported prognostic outcomes. Pooled sensitivity, specificity, negative predictive value (NPV), odds ratios, and hazard ratios (HRs) were estimated using random-effects models. Results: Twenty-three studies (7 TSP-9, 16 p53 IHC; 6655 patients) met inclusion criteria. TSP-9 yielded a higher pooled HR (HR: 7.65; 95% confidence interval: 5.86-9.99) compared with p53 IHC (HR: 5.05; 95% confidence interval: 4.27-5.97). Sensitivities were comparable (TSP-9: 57.1% vs p53 IHC: 60.1%), while p53 IHC demonstrated higher specificity (91.5% vs 83.5%). Both biomarkers exhibited robust NPVs exceeding 90% (p53 IHC: 94.7%; TSP-9: 91.1%). Conclusion: Both TSP-9 and p53 IHC substantially outperform standard histology for risk stratification in Barrett's esophagus. The higher HR with TSP-9 may reflect its multiplexed approach. The strong NPV of both assays supports safely extending surveillance intervals in low-risk patients.
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