Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
J Gastroenterol. 2010 Oct;45(10):1039-44. doi: 10.1007/s00535-010-0264-y. Epub 2010 Jun 15.
The anatomical reference points used to endoscopically diagnose Barrett's esophagus (BE) differ between Japan and other countries. The esophageal gastric junction (EGJ) is defined as the distal limit of the lower esophageal longitudinal or palisade vessels in Japan, but as the proximal margin of the gastric folds (Prague C&M criteria). The aim of this study was to prospectively compare endoscopic BE diagnoses using the Japanese and Prague C&M criteria.
Two endoscopists examined 110 consecutive patients [73 male, 37 female; age, 66.5 ± 8.7 (mean ± standard deviation) years]. Post-gastrectomy, post-esophagectomy, and post-chemoradiotherapy esophageal cancer patients were excluded as subjects.
EGJ identification rates were 95% (104/110) and 86% (95/110) using the Japanese and Prague C&M criteria, respectively (p = 0.039). Among the 110 patients, 43 (39%) and 29 (26%) were diagnosed as having endoscopic BE using the respective criteria (p = 0.044). In atrophic gastritis and reflux esophagitis cases, there was no significant difference in EGJ identification rates between the Japanese and Prague C&M criteria. However, the ratio of endoscopic BE diagnosis using the Japanese criteria was significantly higher than that using the Prague C&M criteria in atrophic gastritis cases (p = 0.03).
There was a significant difference in endoscopic BE diagnostic results between the Japanese and Prague C&M criteria. In the Japanese population, the Japanese criteria may be more suitable for the definition of EGJ and for the diagnosis of endoscopic BE than the Prague C&M criteria.
用于经内镜诊断 Barrett 食管 (BE) 的解剖参考点在日本和其他国家有所不同。在日本，食管胃交界 (EGJ) 定义为食管下段纵向或栅栏状血管的远端界限，但在布拉格 C&M 标准中则定义为胃皱襞的近端边缘。本研究旨在前瞻性比较使用日本和布拉格 C&M 标准进行的内镜 BE 诊断。
两名内镜医师检查了 110 例连续患者[73 例男性，37 例女性；年龄 66.5 ± 8.7(均数 ± 标准差)岁]。排除胃切除术后、食管切除术后和放化疗后食管癌患者。
使用日本和布拉格 C&M 标准，EGJ 识别率分别为 95%(104/110)和 86%(95/110)(p=0.039)。在 110 例患者中，分别有 43(39%)和 29(26%)例根据各自的标准诊断为内镜 BE(p=0.044)。在萎缩性胃炎和反流性食管炎病例中，日本和布拉格 C&M 标准之间 EGJ 识别率无显著差异。然而，在萎缩性胃炎病例中，使用日本标准诊断内镜 BE 的比例明显高于使用布拉格 C&M 标准(p=0.03)。
日本和布拉格 C&M 标准之间内镜 BE 诊断结果存在显著差异。在日本人群中，与布拉格 C&M 标准相比，日本标准可能更适合 EGJ 的定义和内镜 BE 的诊断。
