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Endoscopic diagnosis of Barrett's esophagus

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The Prague C and M Criteria have been developed for the objective endoscopic diagnosis of Barrett's esophagus (BE).BE arises between the squamocolumnar junction and the gastroesophageal junction at the proximal margin of the gastric folds.In this study,we reported that 43.0％ of the subjects examined were diagnosed with BE based on the Prague C and M Criteria.Previous criticism by John Dent proposed that our data should be considered invalid because the prevalence of BE reported in our study was extraordinarily high and discordant with previous studies.Dent predicted that the position of the gastroesophageal junction in our study was judged to be lower than the actual position due to the effacement of the proximal ends of the gastric folds because of the routine use of a high degree of air distension during typical Japanese endoscopic examinations.The endoscopic evaluation of the superior gastric folds is certainly influenced by the degree of air distension of the esophagus.However,in our study,the proximal limit of the gastric mucosal folds was prospectively imaged while the oesophagus was minimally insufflated.Then,under a high level of air distension,the distal ends of the palisade-shaped longitudinal vessels were imaged because they are more easily observed when distended.In the majority of patients,the distal ends of the palisade-shaped longitudinal vessels correspond to the proximal limit of the gastric mucosal folds.Our endoscopic evaluation was appropriately performed according to the Prague C and M Criteria.We suspect that the high prevalence of BE in our study may be due to the inclusion of ultrashort-segment BE,which defines BE with an affected mucosal length under 5 mm,in our positive results.

Barrett's esophagusGastroesophageal junctionSquamocolumnar junctionDigital endoscopic imagesEndoscopy

Tomoyuki Akiyama、Yusuke Sekino、Hiroshi Iida、Shigeru Koyama、Eiji Gotoh、Shin Maeda、Atsushi Nakajima、Masahiko Inamori

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Department of Gastroenterology, Tokyo Metropolitan Hiroo Hospital, Tokyo 150-0013, Japan

Gastroenterology Division, Yokohama City University Hospital, Yokohama 2360004, Japan

Department of Medical Education, Yokohama City University School of Medicine, Yokohama 2360004, Japan

2012

10.3748/wjg.v18.i26.3477

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(26)
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