[Biopsy differential diagnosis of gastroesophageal reflux (GERD)]

In biopsy interpretation of GERD demonstration or exclusion of Barrett's esophagus and its complications (dysplasia and carcinoma) is the main task, especially in its differentiation to cardiac gastritis with intestinal metaplasia. Despite of all molecular-biological examinations till today no biomarker exists for the malignant potential of Barrett's esophagus, therefore regular surveillance is necessary. Differentiation of Barrett's esophagus from cardiac mucosa with intestinal metaplasia is not yet possible by using immunochemistry, also there is no marker for the differential diagnosis of low grade dysplasia versus reactive atypia and high grade dysplasia versus early cancer of mucosa type.