The application of Prague C and M criteria in the diagnosis of Barrett's esophagus in an ethnic Chinese population.
OBJECTIVE
To investigate the prevalence of endoscopically suspected esophageal metaplasia (ESEM) in an ethnic Chinese population by endoscopic and pathologic evaluation and to assess the utility of Prague C and M criteria.


METHODS
Consecutive patients who received esophagogastroduodenoscopy either as a part of therapy for various upper abdominal symptoms or as an annual health check-up were evaluated for the existence of ESEM and Barrett's esophagus (BE). Biopsy with standardized random four pieces every 2 cm from the four quarters of esophagus with ESEM lesion was performed. BE was defined by histological verification of specialized intestinal metaplasia and gastric metaplasia and was categorized according to the Prague C and M criteria.


RESULTS
A total of 5,179 subjects were screened from Jan. 2007 to Dec. 2007. This study enrolled 4,797, including 3,386 for referral endoscopy and 1,411 for screening endoscopy. Prevalence of BE among the referral endoscopy, screening endoscopy, and overall was 1.06%, 0.35%, and 0.85%, respectively. A total of 41 subjects with BE were detected among 93 ESEM subjects. Short segment BE (75.6%, n=31) was more prevalent than long segment BE (24.4%, n=10). The proportions of BE from subjects with ESEM by Prague C and M criteria were C< or =1M1 38.9% (19/50), C< or =1M2 40% (12/30), and CxM> or =3 76.9% (10/13).


CONCLUSIONS
On the basis of the standardized protocol with random four-quadrate endoscopic biopsy, we have demonstrated the utility of Prague C and M criteria to characterize the BE in an ethnic Chinese population.
Chang
Chi-Yang
CY
Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Lee
Yi-Chia
YC
Lee
Ching-Tai
CT
Tu
Chia-Hung
CH
Hwang
Jau-Chung
JC
Chiang
Hung
H
Tai
Chi-Ming
CM
Chiang
Tsung-Hsien
TH
Wu
Ming-Shiang
MS
Lin
Jaw-Town
JT
D044466:Asian People; D001471:Barrett Esophagus / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology