Necessity of pathological examination of reflux esophagitis

Background: Routine biopsies are not recommended in the guidelines for RE patients, whereas upper gastrointestinal endoscopy combined with histopathological examination is necessary for RE patients with high-risk factors. Methods: : The medical records of 613 patients with RE who had undergone upper gastrointestinal endoscopy and biopsy for histopathological examination were collected. Relevant and risk factors for pathological outcomes were analyzed. Result: The proportions of middle-aged and male participants were higher. The pathological outcome was related to age and endoscopic findings, but not sex. Age is a risk factor for intestinal metaplasia and is associated with esophagitis severity. Esophageal mucosa status, white moss, and hemostasis with adrenaline are relevant with LIN,only mucosal status is a risk factor. LA Grade is a significant risk factor for HIN. Mucosa status and white moss are both risk factors for erosive ulcer and pathological follow-up necessity. Conclusion: Biopsy and pathological follow-up of cases with risk factors, especially endoscopic mucosal abnormalities, help screen for precancerous lesions and reduce misdiagnosis.