Narrowing the Discrepancy in Interobserver Variability With Barrett’s Esophagus With Low-Grade Dysplasia: Will Biomarkers or Risk Testing Help?

The management of Barrett’s esophagus (BE) with low-grade dysplasia (BE-LGD) remains a unique challenge. Those challenges include high interobserver variability among pathologists, variable natural history of BE-LGD and neoplastic progression, and the lack of established and validated risk prediction tools to guide management of patients with BE-LGD. Current guidelines recommend a patient-centered approach and acknowledge endoscopic eradication therapy and surveillance are acceptable management strategies. Emerging risk assessment tools incorporating clinical, histological, morphological, epigenetic, or molecular features may assist in appropriate stratification. This article reviews the current literature of risk stratification tools in patients with BE-LGD.