Review article: towards consistency in the endoscopic diagnosis of Barrett's oesophagus and columnar metaplasia - PubMed (original) (raw)

Review

Review article: towards consistency in the endoscopic diagnosis of Barrett's oesophagus and columnar metaplasia

D Armstrong. Aliment Pharmacol Ther. 2004 Oct.

Abstract

Barrett's oesophagus is associated with severe reflux disease and is a risk factor for oesophageal adenocarcinoma. However, there is a lack of consensus on how to assess the presence and extent of Barrett's oesophagus in clinical practice. A diagnosis of Barrett's oesophagus is currently based on the recognition of an abnormal oesophageal mucosa at endoscopy. However, a diagnosis cannot be made solely on this basis, and a true diagnosis requires the identification of an area suspicious for columnar metaplasia at endoscopy, followed by histological confirmation. Currently, difficulties in the assessment of Barrett's oesophagus include a lack of consistent definitions of endoscopic landmarks (such as the gastro-oesophageal and squamo-columnar junctions), a lack of standardization of descriptions of the extent of Barrett's oesophagus, and limited communication between the endoscopist and the pathologist, which hampers accurate histological confirmation. It is therefore important to develop an endoscopic description of Barrett's oesophagus, with a clear definition of endoscopic landmarks, to determine, amongst other things, whether anti-reflux therapy produces regression or a reduction in the length of Barrett's oesophagus. With this background, a subgroup of the International Working Group on the Classification of Oesophagitis was charged with developing a simple, practicable classification system, suitable for use with standard endoscopes, which would be easy to apply in clinical practice and in large clinical studies. Described in this review are a series of propositions and an overview of the 'CM classification', developed by the International Working Group on the Classification of Oesophagitis, to facilitate the endoscopic description of Barrett's oesophagus. It is hoped that these propositions will be the first step in the development of standard endoscopic diagnostic criteria for Barrett's oesophagus, relevant to clinical practice and clinical research.

PubMed Disclaimer

Similar articles

• Review article: prevalence of Barrett's oesophagus and metaplasia at the gastro-oesophageal junction.
  Sharma P. Sharma P. Aliment Pharmacol Ther. 2004 Oct;20 Suppl 5:48-54; discussion 61-2. doi: 10.1111/j.1365-2036.2004.02138.x. Aliment Pharmacol Ther. 2004. PMID: 15456464 Review.
• When and how to grade Barrett's columnar metaplasia: the Prague system.
  Anand O, Wani S, Sharma P. Anand O, et al. Best Pract Res Clin Gastroenterol. 2008;22(4):661-9. doi: 10.1016/j.bpg.2008.02.001. Best Pract Res Clin Gastroenterol. 2008. PMID: 18656823 Review.
• Diagnosis and treatment of Barrett's oesophagus. A general survey.
  Petrakis IE, Sciacca V, Iascone C. Petrakis IE, et al. Acta Chir Belg. 2001 Mar-Apr;101(2):53-8. Acta Chir Belg. 2001. PMID: 11396051 Review.
• The Munich Barrett follow up study: suspicion of Barrett's oesophagus based on either endoscopy or histology only--what is the clinical significance?
  Meining A, Ott R, Becker I, Hahn S, Mühlen J, Werner M, Höfler H, Classen M, Heldwein W, Rösch T. Meining A, et al. Gut. 2004 Oct;53(10):1402-7. doi: 10.1136/gut.2003.036822. Gut. 2004. PMID: 15361485 Free PMC article.
• Barrett's oesophagus: the new endoscopic modalities have a future.
  Deviere J. Deviere J. Gut. 2005 Mar;54 Suppl 1(Suppl 1):i33-7. doi: 10.1136/gut.2004.041574. Gut. 2005. PMID: 15711006 Free PMC article. Review.

Cited by

• A substantial incidence of silent short segment endoscopically suspected esophageal metaplasia in an adult Japanese primary care practice.
  Shimoyama S, Ogawa T, Toma T, Hirano K, Noji S. Shimoyama S, et al. World J Gastrointest Endosc. 2012 Feb 16;4(2):38-44. doi: 10.4253/wjge.v4.i2.38. World J Gastrointest Endosc. 2012. PMID: 22347531 Free PMC article.
• The definition and management of Barrett's oesophagus: a case report, review of the literature and a suggestion for the future.
  Bird-Lieberman EL, Lao-Sirieix P, Saeed I, Khoo D, Burnham R, Fitzgerald R. Bird-Lieberman EL, et al. BMJ Case Rep. 2009;2009:bcr07.2008.0450. doi: 10.1136/bcr.07.2008.0450. Epub 2009 Jun 1. BMJ Case Rep. 2009. PMID: 21686804 Free PMC article.
• Diagnosis and Surveillance of Barrett's Esophagus: Addressing the Transatlantic Divide.
  Ghaus S, Neumann H, Muhammad H, Tontini GE, Ishaq S. Ghaus S, et al. Dig Dis Sci. 2016 Aug;61(8):2185-2193. doi: 10.1007/s10620-016-4138-x. Epub 2016 Apr 1. Dig Dis Sci. 2016. PMID: 27038446 Review.
• Barrett's esophagus: Incidence, etiology, pathophysiology, prevention and treatment.
  Modiano N, Gerson LB. Modiano N, et al. Ther Clin Risk Manag. 2007 Dec;3(6):1035-145. Ther Clin Risk Manag. 2007. PMID: 18516262 Free PMC article.
• Endoscopic diagnosis and screening of Barrett's esophagus: Inconsistency of diagnostic criteria between Japan and Western countries.
  Ishimura N, Okimoto E, Shibagaki K, Ishihara S. Ishimura N, et al. DEN Open. 2021 Nov 15;2(1):e73. doi: 10.1002/deo2.73. eCollection 2022 Apr. DEN Open. 2021. PMID: 35310704 Free PMC article. Review.

Publication types

MeSH terms

LinkOut - more resources

• Full Text Sources

  • Ovid Technologies, Inc.