Advances in the diagnosis and surveillance of Barrett's esophagus (with videos)

Gastrointest Endosc. 2019 Sep;90(3):325-334. doi: 10.1016/j.gie.2019.05.004. Epub 2019 May 18.


Background and aims: Most patients diagnosed with esophageal adenocarcinoma do not carry a known diagnosis of Barrett's esophagus (BE), suggesting that an improved approach to screening may potentially be of benefit. The use of dysplasia as a biomarker and random biopsy protocols for its detection has limitations. In addition, detecting and appropriately classifying dysplasia in patients with known BE can be difficult.

Methods: This document reviews several technologies with a recently established or potential role in the diagnosis and/or surveillance of BE as well as risk stratification for progression to esophageal adenocarcinoma.

Results: Two technologies were reviewed for imaging or tissue sampling: (1) wide-area transepithelial sampling and (2) volumetric laser endomicroscopy. Four technologies were reviewed for molecular and biomarker technologies for diagnosis and risk stratification: (1) Cytosponge, (2) mutational load, (3) fluorescence in situ hybridization, and (4) immunohistochemistry.

Conclusion: Several technologies discussed in this document may improve dysplasia detection in BE in a wide-field manner. Moreover, the addition of different biomarkers may aid in enhanced risk stratification to optimize approaches to surveillance or treatment for patients with BE.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Barrett Esophagus / diagnosis*
  • Barrett Esophagus / metabolism
  • Barrett Esophagus / pathology
  • Biopsy / methods
  • Disease Progression
  • Esophageal Neoplasms / epidemiology*
  • Esophagoscopy / methods
  • Humans
  • Imaging, Three-Dimensional
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Microscopy, Confocal / methods
  • Risk Assessment
  • Watchful Waiting

Supplementary concepts

  • Adenocarcinoma Of Esophagus