Early Implementation of TSP-9 for Risk Stratification in Barrett’s Esophagus: Influence on Management Decisions in Latin America

Risk stratification in Barrett’s esophagus (BE) remains imperfect despite guideline-based surveillance. Tissue Systems Pathology-9 Test (TSP-9; TissueCypher™) is a molecular assay identifying patients at higher progression risk, but data from Latin America are lacking. We prospectively evaluated TSP-9 implementation in consecutive BE patients at a tertiary foregut center in Buenos Aires, Argentina (January 2023-December 2025). Among 10 endoscopic eradication therapy (EET)-naïve patients, TSP-9 classified 5 as low risk, 1 as intermediate, and 4 as high risk. Management was modified in 50% of cases, all escalations from surveillance to EET, aligning with molecular risk. Two post-EET cases were analyzed separately.