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Barrett esophagus in Asia: same disease with different pattern.

Lee HS, Jeon SW - Clin Endosc (2014)

Bottom Line: However, the disease pattern of BE in Asia differs from that observed in the West.Helicobacter pylori infection is more prevalent in Asia than in the West.We suggest larger studies with a prospective design be conducted to elaborate further the different patterns of BE in Asia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
Barrett esophagus (BE) is considered to develop as a result of chronic gastroesophageal reflux disease (GERD) and to predispose to esophageal adenocarcinoma (EAC). However, the disease pattern of BE in Asia differs from that observed in the West. For example, in the West, the prevalence rates of BE and EAC have progressively increased, whereas although the prevalence rate of GERD is increasing in Asia, the prevalence rates of BE and EAC have remained low in most Asian countries. GERD, hiatal hernia, old age, male sex, abdominal obesity (visceral obesity), smoking, alcohol consumption, and kyphosis are known risk factors for BE in Asia, and most Asian patients have short-segment BE. Helicobacter pylori infection is more prevalent in Asia than in the West. We suggest larger studies with a prospective design be conducted to elaborate further the different patterns of BE in Asia.

No MeSH data available.


Related in: MedlinePlus

The Prague classification of Barrett esophagus. The Prague C&M classification uses the C value for the circumferential pattern (C) and the M value for the maximum length (M) (including tongue-like pattern).
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Figure 2: The Prague classification of Barrett esophagus. The Prague C&M classification uses the C value for the circumferential pattern (C) and the M value for the maximum length (M) (including tongue-like pattern).

Mentions: Evidence regarding the reliability of the endoscopic diagnosis of BE is extremely limited in Asia.10 The Asia Barrett's Consortium recently conducted a multinational trial using video clips of patients with BE to determine interobserver reliability for BE grading by Asian endoscopists.44 The study was performed following rigorous training of endoscopists with respect to the use of the Prague C&M classification (Fig. 2) for BE diagnosis and grading.45 Reliability coefficients for the recognition of BE extending ≥1 cm were 0.90 (range, 0.80 to 1.00) and 0.92 (range, 0.87 to 0.98) for Prague C&M values, respectively, but were markedly lower (0.18 [range, 0.03 to 0.32] and 0.21 [range, 0.00 to 0.51], respectively) for BE segments <1 cm. Accordingly, it was concluded that the endoscopic diagnosis of BE has an unacceptably low interobserver reliability for very short segment disease (<1 cm).44 In a similar study conducted in the West, we identified an abrupt drop in reliability coefficients when assessing videos with mean C&M values <1 cm. The consistency of this finding in Asia and the West suggests that SS BE is difficult to diagnose consistently.45-47


Barrett esophagus in Asia: same disease with different pattern.

Lee HS, Jeon SW - Clin Endosc (2014)

The Prague classification of Barrett esophagus. The Prague C&M classification uses the C value for the circumferential pattern (C) and the M value for the maximum length (M) (including tongue-like pattern).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928486&req=5

Figure 2: The Prague classification of Barrett esophagus. The Prague C&M classification uses the C value for the circumferential pattern (C) and the M value for the maximum length (M) (including tongue-like pattern).
Mentions: Evidence regarding the reliability of the endoscopic diagnosis of BE is extremely limited in Asia.10 The Asia Barrett's Consortium recently conducted a multinational trial using video clips of patients with BE to determine interobserver reliability for BE grading by Asian endoscopists.44 The study was performed following rigorous training of endoscopists with respect to the use of the Prague C&M classification (Fig. 2) for BE diagnosis and grading.45 Reliability coefficients for the recognition of BE extending ≥1 cm were 0.90 (range, 0.80 to 1.00) and 0.92 (range, 0.87 to 0.98) for Prague C&M values, respectively, but were markedly lower (0.18 [range, 0.03 to 0.32] and 0.21 [range, 0.00 to 0.51], respectively) for BE segments <1 cm. Accordingly, it was concluded that the endoscopic diagnosis of BE has an unacceptably low interobserver reliability for very short segment disease (<1 cm).44 In a similar study conducted in the West, we identified an abrupt drop in reliability coefficients when assessing videos with mean C&M values <1 cm. The consistency of this finding in Asia and the West suggests that SS BE is difficult to diagnose consistently.45-47

Bottom Line: However, the disease pattern of BE in Asia differs from that observed in the West.Helicobacter pylori infection is more prevalent in Asia than in the West.We suggest larger studies with a prospective design be conducted to elaborate further the different patterns of BE in Asia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT
Barrett esophagus (BE) is considered to develop as a result of chronic gastroesophageal reflux disease (GERD) and to predispose to esophageal adenocarcinoma (EAC). However, the disease pattern of BE in Asia differs from that observed in the West. For example, in the West, the prevalence rates of BE and EAC have progressively increased, whereas although the prevalence rate of GERD is increasing in Asia, the prevalence rates of BE and EAC have remained low in most Asian countries. GERD, hiatal hernia, old age, male sex, abdominal obesity (visceral obesity), smoking, alcohol consumption, and kyphosis are known risk factors for BE in Asia, and most Asian patients have short-segment BE. Helicobacter pylori infection is more prevalent in Asia than in the West. We suggest larger studies with a prospective design be conducted to elaborate further the different patterns of BE in Asia.

No MeSH data available.


Related in: MedlinePlus