Association of Barrett’s esophagus with non-goblet esophageal columnar epithelium: appraisal of the surrounding controversies

Barrett’s esophagus (BE) predisposes to esophageal adenocarcinoma (EAC) and significantly increases its incidence. However, the precise diagnostic criteria of BE are not consistent internationally. The definition of BE is still controversial because two types of metaplastic epithelia have been identified: gobletcell columnar epithelium (GCE), and non-goblet-cell columnar epithelium (NGCE). The identification of goblet cells, which is currently a prerequisite for the diagnosis of BE according to the American college of gastroenterology (ACG), may not be a sensitive indicator for the evaluation of neoplasia risk in these patients. We discuss the most recent advances in understanding the relation between BE and NGCE, as well as the key molecular features of malignancy in these patients. There exists a lack of international consensus at this time on whether to include non-goblet metaplasia in the definition of BE.