BARRETT'S ESOPHAGUS-FACT SHEET

Definition
A change of any length that is found in the esophagus and is shown to have intestinal
metaplasia on biopsy (US definition). In Japan and the United Kingdom, intestinal metaplasia
is not required.
Incidence and location
Common; found in 5% to 8% of individuals with gastroesophageal reflux disease.
Morbidity and Mortality
Barrett's esophagus in and of itself does not result in mortality but is a strong risk factor for
esophageal adenocarcinoma, with an estimated annual rate of transformation of approximately
0.5%.
Gender, Race, and Age Distribution
Strong white male predominance with median age in the early 50s.
Clinical Features
Symptomatic reflux usually leads to biopsy, but the Barrett's esophagus itself is
asymptomatic; in fact, once metaplasia occurs, reflux symptoms are said to decrease.
BARRETT'S ESOPHAGUS-PATHOLOGIC FEATURES
Gross Findings
Salmon-colored velvety mucosa in the esophagus
Originates distally and progresses proximally
Microscopic Findings
Usually incomplete intestinal metaplasia (goblet cells interspersed with cells resembling
gastric foveolar cells)
Examples: epithelial changes graded as indefinite for dysplasia, low-grade dysplasia, or
high-grade dysplasia
Immunohistochemistry
CK7+, Dasl +, racemase+, CDX2+, MUC2+, variable MUC SAC, and MUC6
Differential Diagnosis
With intestinal metaplasia of the gastric cardia; requires clinicopathologic correlation