score/[id]

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CLASSIFICATION
Classification
Barrett esophagus (Japanese definition, SSBE/LSBE)
In Japan the EGJ is the lower end of the palisade vessels, and columnar epithelium oral to it is Barrett esophagus. Length <3 cm is SSBE and ≥3 cm is LSBE. Record C and M with Prague. Intestinal metaplasia is not required for the Japanese endoscopic diagnosis.
Classification overview
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Landmarks
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EGJ · Lower end of palisade vessels
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Definition
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Definition · Columnar epithelium oral to the EGJ
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Length
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SSBE · Short segment <3 cm
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LSBE · Long segment ≥3 cm
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Measurement
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Prague · C and M
Landmarks
EGJ
Lower end of palisade vessels
Japan
The EGJ is the lower end of the palisade vessels in the distal esophagus. If those vessels are unclear, use the oral end of the gastric mucosal folds
West
Prague and Siewert use the tops of the gastric mucosal folds as the zero point
SCJ
The Z-line (SCJ) may not coincide with the EGJ. Columnar epithelium oral to the EGJ is Barrett esophagus
Note: Palisade vessels are often hard to see with a hernia or Barrett segment; then use the fold tops.
Definition
Definition
Columnar epithelium oral to the EGJ
Japan
Barrett esophagus is columnar epithelium in the esophagus. Intestinal metaplasia is not required for the endoscopic diagnosis
West
Many definitions also require intestinal metaplasia on biopsy of salmon-colored mucosa
Length
SSBE
Short segment <3 cm
Definition
Maximum length of columnar epithelium <3 cm
Report
A tongue-only segment is Prague C0M<3. Record C and M on the Prague page
LSBE
Long segment ≥3 cm
Definition
Maximum length of columnar epithelium ≥3 cm
Risk
Longer segments have higher adenocarcinoma risk. Record Prague C and M and plan surveillance
Measurement
Prague
C and M
C
Circumferential columnar extent from the EGJ, in centimetres
M
Maximum extent (circumferential segment plus tongue), in centimetres. Do not take M as the tongue alone
Note: Measurement steps are on the Prague page. This page is the Japanese definition and SSBE/LSBE.
JCE 2017, Original
Oyanagi 2022, Not original, CC BY
Reference
Original article
日本食道学会. 食道癌取扱い規約 第11版. 金原出版
Japanese reference
Japan Esophageal Society. Esophagus 2017;14:1-36 (11th ed., Part I)
Related study
Sharma P, Morales TG, Sampliner RE. Am J Gastroenterol 1998;93:1033-1036
Related study
Sharma P et al. Gastroenterology 2006;131:1392-1399 (Prague C & M)
Related tools
Prague C & M (Barrett esophagus)
C and M measurement
CLASSIFICATION
Prague
→
BING classification (Barrett NBI)
NBI prediction of dysplasia
CLASSIFICATION
BING
→
JES classification (esophageal squamous, magnifying)
Squamous magnifying classification
CLASSIFICATION
JES
→
Paris classification (superficial morphology)
Superficial morphology
CLASSIFICATION
Paris
→
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Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.