Barrett’s Esophagus and Human Epidermal Growth Factor 2 Status in Patients with Gastroesophageal Reflux Disease

Background: Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal condition and a key risk factor for Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Identifying reliable biomarkers, such as Human Epidermal Growth Factor 2 (HER2), could improve early detection and management. This study aimed to determine the frequency of Barrett’s esophagus among GERD patients and evaluate HER2 expression in relation to dysplasia and carcinoma. Methods: This prospective cross-sectional study included 193 patients with chronic GERD symptoms who underwent clinical evaluation, laboratory testing, upper GI endoscopy with biopsies, and histopathological examination. HER2/neu expression was assessed immunohistochemically and scored per standardized criteria. Results: Barrett’s esophagus was diagnosed in 5.7% of GERD patients, predominantly short-segment (72.7%). BE was significantly associated with age ≥50 years (81.8%, p = 0.033), obesity (81.8%, p = 0.034), smoking (90.9%, p = 0.047), hiatal hernia (90.9%, p = 0.004), and H. pylori infection (63.6%, p = 0.009). Male sex showed a higher frequency, but the difference was not statistically significant (p = 0.085). HER2/neu overexpression was found in all EAC cases (100%), 63.6% of BE cases, but only in 5.4% of erosive reflux disease (ERD) and 4.6% of non-erosive reflux disease (NERD) cases (p<0.001). HER2 demonstrated a sensitivity of 63.6% and specificity of 95% for detecting BE (AUC = 0.793). Conclusion: Endoscopic surveillance in GERD patients is critical for early detection of BE and EAC. High HER2 expression correlates with advanced dysplasia and EAC, supporting its utility as an early biomarker and potential therapeutic target.