Barrett’s Esophagus and Human Epidermal Growth Factor 2 Status in Patients with Gastroesophageal Reflux Disease | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 09 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.421607.4170 | ||
| Authors | ||
| Emad A. Moustafa1; Mai Ahmed Gobran2; Menna Allah Mohamed Diab* 3; Nahla El-Sayed El-Gammal4 | ||
| 1Assistant Professor of Hepatology, Gastroenterology, and Infectious Diseases, Faculty of Medicine - Zagazig University | ||
| 2Assistant Professor of Pathology, Faculty of Medicine - Zagazig University | ||
| 3Resident of Hepatology, Gastroenterology, and Infectious diseases, Faculty of Medicine, Zagazig University | ||
| 4Professor of Hepatology, Gastroenterology and Infectious diseases, Faculty of Medicine - Zagazig University | ||
| Abstract | ||
| Background: Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal condition and a key risk factor for Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Identifying reliable biomarkers, such as Human Epidermal Growth Factor 2 (HER2), could improve early detection and management. This study aimed to determine the frequency of Barrett’s esophagus among GERD patients and evaluate HER2 expression in relation to dysplasia and carcinoma. Methods: This prospective cross-sectional study included 193 patients with chronic GERD symptoms who underwent clinical evaluation, laboratory testing, upper GI endoscopy with biopsies, and histopathological examination. HER2/neu expression was assessed immunohistochemically and scored per standardized criteria. Results: Barrett’s esophagus was diagnosed in 5.7% of GERD patients, predominantly short-segment (72.7%). BE was significantly associated with age ≥50 years (81.8%, p = 0.033), obesity (81.8%, p = 0.034), smoking (90.9%, p = 0.047), hiatal hernia (90.9%, p = 0.004), and H. pylori infection (63.6%, p = 0.009). Male sex showed a higher frequency, but the difference was not statistically significant (p = 0.085). HER2/neu overexpression was found in all EAC cases (100%), 63.6% of BE cases, but only in 5.4% of erosive reflux disease (ERD) and 4.6% of non-erosive reflux disease (NERD) cases (p<0.001). HER2 demonstrated a sensitivity of 63.6% and specificity of 95% for detecting BE (AUC = 0.793). Conclusion: Endoscopic surveillance in GERD patients is critical for early detection of BE and EAC. High HER2 expression correlates with advanced dysplasia and EAC, supporting its utility as an early biomarker and potential therapeutic target. | ||
| Keywords | ||
| Barrett’s Esophagus; Human Epidermal Growth Factor 2; Gastroesophageal Reflux Disease | ||
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