[Risk estimation in Barrett's esophagus: biomolecular marker and histopathologic classification]

The diagnosis of Barrett's esophagus and the different degrees of intraepithelial neoplasia appear to be demanding in several aspects. Current data on genetic alterations involved in the carcinogenesis of Barrett's esophagus are discussed. Several new biomarkers are being tested to help better to determine the risk of cancer development. However, a few immunohistochemical markers have emerged which could be helpful for the differential diagnosis of low- and high-grade intraepithelial neoplasia. Markers which could predict the progression of premalignant Barrett's epithelium to carcinoma are still to be established. At present, the "gold standard" for classifying the malignant potential in Barrett's esophagus is the degree of intraepithelial neoplasia found on standard biopsy protocols.