Korean J Gastrointest Endosc.  2007 May;34(5):239-243.

Prevalence of the Endoscopic Barrett's Esophagus Determined by Palisading Vessel and Inter-observer Variation

Affiliations
  • 1Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jhlee409@amc.seoul.kr

Abstract

BACKGROUND/AIMS
The Barrett's esophagus is confirmed by performing a biopsy when the gastroesophageal junction (GEJ) and Z-line do not coincide. In Japan, the GEJ is at the distal end of the palisading vessel while Western countries define it as the proximal tip of the gastric fold. However, there is little data on the prevalence of an endoscopic Barrett's esophagus and the inter-observer variation.
METHODS
Four experienced endoscopists reviewed the endoscopic still images of 111 consecutive patients. The level of inter-observer agreement was expressed as a kappa value.
RESULTS
The average percentage of patients with an endoscopically confirmed esophagus was 34.2%. The level of inter-observer agreement was substantial (kappa=0.698).
CONCLUSIONS
The prevalence of an endoscopic confirmed Barrett's esophagus was high, and the inter-observer variation was substantial when the GEJ was defined as the distal end of the palisading vessel. Considering the low incidence of esophageal adenocarcinoma and the risk of hemorrhage from a biopsy, a more specific marker is needed in this high-risk group.

Keyword

Barrett's esophagus; Esophageal adenocarcinoma; Gastroesophageal junction; Palisading vessel
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