Biomarker Use in Barrett's Esophagus Surveillance

Barrett's esophagus (BE) is the established precursor to esophageal adenocarcinoma; however, the overwhelming majority of patients with BE never progress to cancer. Therefore, there is a clinical need to identify the patients with BE who are at high risk of progression from the patients with BE who will not progress. Histologic dysplasia has served as the marker of progression risk on which clinical decisions are made. However, dysplasia assessment in practice has been hindered by high interobserver variability. As such, many studies to develop validated biomarkers that either assist in dysplasia assessment or independently serve as predictors of progression risk have been performed. In this review, we will summarize some of these studies, primarily focused on p53, abnormal genomic content, and methylated DNA markers, which have shown promise for their ability to identify patients at increased risk of progressing to more advanced disease.