Minimally Invasive Molecular Approaches for the Detection of Barrett's Esophagus- High Grade Dysplasia and Esophageal Adenocarcinoma

Inclusion criteria

• Patient between the ages 18 - 90
• Patients with a BE segment >= 1cm in maximal extent endoscopically
• Histology showing evidence of intestinal metaplasia with or without presence of dysplasia
• Undergoing clinically indicated endoscopy

Exclusion criteria

• Patients with a prior history of ablation (photodynamic therapy, radiofrequency ablation, cryotherapy, argon plasma coagulation). Patients with a history of endoscopic mucosal resection alone will not be excluded
• Patients with a history of esophageal or gastric resection for esophageal or gastric carcinoma
• Subjects with known evidence of BE (on history or review of medical records)

• Pregnant or lactating females
• Patients who are unable to consent
• Patients with a current history of uninvestigated dysphagia (this does not apply to the brushings/biopsies only portion of the study for RST/ARZ sites only)
• History of eosinophilic esophagitis or achalasia
• Patients on oral anticoagulation including Coumadin, and warfarin, unless discontinued for thee to five days prior to the sponge procedure. (This does not apply to the brushing/biopsy only portion of the study for RST/ARZ sites only)
• Patients on antiplatelet agents including clopidogrel, unless discontinued for three to five days prior to the sponge procedure. (This does not apply to the brushing/biopsy only portion of the study for RST/ARZ sites only)
• Patients on oral thrombin inhibitors including dabigatran and oral factor X an inhibitor such as rivaroxaban, apixaban, and edoxaban, unless discontinued for three to five days prior to the sponge procedure. (This does not apply to the brushing/biopsy only portion of the study for RST/ARZ sites only)
• Patients with a history of known esophageal or gastric varices or cirrhosis
• Patients with a history of esophageal or gastric resection
• Patients with congenital or acquired bleeding diatheses
• Patients with a history of esophageal squamous dysplasia
• Patient has known carcinoma of the foregut (pancreatic, bile duct, ampullary, stomach, or duodenum) within 5 years prior to study enrollment
• Patient has received chemotherapy class drugs or radiation to treat mediastinal or esophageal cancer
• Patients with Familial Adenomatous Polyposis (FAP) or Lynch Syndrome