Differences in the endoscopic detection rates of Barrett’s esophagus using the Japanese and Western criteria: a pilot study

Abstract

Background and aim

Identification of the esophageal gastric junction (EGJ) is of crucial importance for the consistent detection of Barrett's esophagus (BE). In Japan, the distal end of the lower esophageal palisade vessels is used to define the EGJ. However, in Western countries, the EGJ is defined as the proximal margin of the gastric folds. In this prospective study, we compared the variation in endoscopic diagnosis of BE using the Japanese criteria (J-criteria) and the Prague C & M criteria (P-criteria) as a landmark of the EGJ.

Methods

A total of 82 patients were enrolled in this study. The patients were referred to the Veterans Affair Palo Alto Health Care System from May 2008 to July 2008. We assessed the recognition rates of the EGJ and the detection rates of endoscopic BE, first using the J-criteria and later using the P-criteria by the American endoscopists.

Results

Identification rate of EGJ was 87.8 % (72/82) using the J-criteria and 97.5 % (80/82) using the P-criteria (P = 0.008). 28.0 % (23/82) of the cases were endoscopically diagnosed as BE using the J-criteria, whereas 17.0 % (14/82) of the cases were diagnosed as BE using the P-criteria (P = 0.049). There was a significant difference in the detection rates between the J-criteria and P-criteria.

Conclusions

We showed the different ratios in the endoscopic detection of BE using the J-criteria and P-criteria. The difference in the prevalence rate of BE in Japan and Western countries can be partly attributed to differences in the endoscopic diagnose of BE.

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