A study looking at different tests to find cell changes in people with Barrett’s oesophagus (ACE-B)

Cancer type:

Oesophageal cancer





This study looked at different types of endoscopy tests to find cell changes in people with Barrett’s oesophagus.

The study was supported by Cancer Research UK. It was open for people to join between 2017 and 2019.The team published the results in 2022.

More about this trial

Barrett’s oesophagus is a condition where the cell lining of the oesophagus (food pipe) changes. The cells become more like cells of the stomach or small bowel. 
Some people with Barrett’s oesophagus develop cancer of the oesophagus (oesophageal cancer). So they have regular checks to look for signs of cancer. Doctors do this using a small camera on a thin flexible tube (endoscope). This test is called an endoscopy
In this study, the researchers looked at two different kinds of endoscopy:
  • autofluorescence imaging (AFI)
  • probe based Confocal Laser Endomicroscopy (pCLE)

Standard endoscopes use a white light to show up cell changes. AFI has a special filter that helps show up changes more clearly.
pCLE is a microscope that is passed down the endoscope. This helps doctors see details of the cells during the endoscopy. 

Doctors use these 2 techniques at the same time in an AFI pCLE endoscopy. People taking part in this study had an AFI pCLE endoscopy, and a standard endoscopy.
The main aim of this study was to find out if these endoscopy techniques could help identify cell changes in people with Barrett’s oesophagus.

Summary of results

Study design
This study was for people with Barrett’s oesophagus. They were due to have a routine endoscopy to check for cell changes. 

Everyone taking part had:

  • a standard endoscopy
  • autofluorescence imaging (AFI) and probe based confocal laser endomicroscopy (pCLE) 
  • biopsies taken for laboratory analysis

The research team also looked at tissue samples to see if people had these 3 biomarkers:

  • a protein called p53
  • a protein called cyclinA
  • a different number of chromosomes (genetic material) than is usual

A total 134 people had both types of endoscopy as part of this trial:

  • half had a standard endoscopy first, then an AFI pCLE endoscopy 6 to 12 weeks later
  • half had an AFI pCLE endoscopy first, then a standard endoscopy 6 to 12 weeks later

The research team looked at how accurate the different types of endoscopy were. 

They found that the AFI pCLE endoscopy was as accurate as the standard endoscopy. They also found that using the 3 biomarkers could help identify more cell changes than standard endoscopy.

The team concluded that AFI pCLE endoscopies are as good as standard endoscopies for people with Barrett’s oesophagus. And that biomarkers can help make the test more accurate.

More detailed information
There is more information about this research in the reference below. 

Please note, this article is not in plain English. It has been written for health care professionals and researchers.

Journal articles
Image-Enhanced Endoscopy and Molecular Biomarkers Vs Seattle Protocol to Diagnose Dysplasia in Barrett’s Esophagus
M Vithayathil and others
Clinical Gastroenterology and Hepatology. Published online February 2022.

Where this information comes from    
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Massimiliano di Pietro

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
Cambridge University Hospitals NHS Foundation Trust
Cancer Research UK Cambridge Institute
Medical Research Council (MRC)
National Institute of Health Research (NIHR)
University of Cambridge

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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