title: Barrett's oesophagus and associated dysplasia are not equally distributed within the esophageal circumference.
abstract: BACKGROUND
  A careful endoscopic surveillance of Barrett's oesophagus is warranted to prevent esophageal cancer.
  
  
  OBJECTIVE
  To identify the preferred location of non-circumferential Barrett's oesophagus and associated dysplasia within the esophageal circumference.
  
  
  METHODS
  We retrospectively reviewed a prospectively maintained database of patients with non-circumferential lesions. The location of metaplastic lesions and dysplastic lesions within the esophageal circumference was identified as on a clock face, and their distribution in the 4 quadrants was compared.
  
  
  RESULTS
  Of overall 443 patients with Barrett's oesophagus, 192 (43%) were eligible for our study. Multiple lesions were diagnosed in 110 (57%) of them, for a total amount of 352 metaplastic areas. Barrett's oesophagus lesions were located significantly more in the posterior wall of the oesophagus (38.4%), rather than in the right wall (28.8%), the anterior wall (22.6%), or the left wall (10.2%) (P<0.0001). Among all metaplastic lesions, 28 were associated with dysplasia (7.9%), and one with adenocarcinoma (0.3%). Dysplastic lesions were significantly more common in the posterior wall (39.3%) than, respectively, in the anterior wall (35.8%), the right wall (21.4%) or the left wall (3.5%) (P=0.03).
  
  
  CONCLUSIONS
  Our results show that the posterior wall of the oesophagus is the preferential location of both Barrett's oesophagus and associated dysplasia.
authors.affiliation: Internal Medicine, Gastroenterology and Liver Unit, Catholic University of Rome, Italy. Electronic address: s.bibbo@gmail.com.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bibbò
authors.affiliation: Internal Medicine, Gastroenterology and Liver Unit, Catholic University of Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ianiro
authors.affiliation: Institute of Pathology, Catholic University of Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ricci
authors.affiliation: Institute of Pathology, Catholic University of Rome, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Arciuolo
authors.affiliation: Surgical Endoscopy Unit, Catholic University of Rome, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Petruzziello
authors.affiliation: Surgical Endoscopy Unit, Catholic University of Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spada
authors.affiliation: Surgical Endoscopy Unit, Catholic University of Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Larghi
authors.affiliation: Surgical Endoscopy Unit, Catholic University of Rome, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Riccioni
authors.affiliation: Internal Medicine, Gastroenterology and Liver Unit, Catholic University of Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Surgical Endoscopy Unit, Catholic University of Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
authors.affiliation: Internal Medicine, Gastroenterology and Liver Unit, Catholic University of Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cammarota
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications* / Q000473:pathology*; D016208:Databases, Factual; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Cancer screening; Endoscopic surveillance; Localization; Metaplasia