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CLASSIFICATION
Classification
Prague C & M (Barrett esophagus)
Records the endoscopic extent of Barrett esophagus as circumferential (C) and maximum (M) length from the gastroesophageal junction.
Classification overview
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Landmarks
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GEJ · Gastroesophageal junction
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Measurement
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C · Circumferential extent
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M · Maximum extent
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Examples
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C2M5 · Example: C 2 cm, M 5 cm
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C0M1 · Example: tongue only
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C2M2 · Example: circular, no tongue
Landmarks
GEJ
Gastroesophageal junction
Landmark
Tops of the gastric mucosal folds, assessed with moderate insufflation
Hernia
If hiatus hernia is present, do not mistake the diaphragmatic hiatal impression for the gastroesophageal junction
Measurement
C
Circumferential extent
Definition
Circumferential extent of columnar-appearing mucosa above the gastroesophageal junction, in centimetres
C0
A segment made entirely of tongues has C = 0
M
Maximum extent
Definition
Maximum extent of columnar-appearing mucosa above the gastroesophageal junction, including the longest tongue, in centimetres
Rule
M cannot be less than C. Separate islands of columnar mucosa are recorded descriptively and are not included in M
Note: A common error is to take M as the tongue length only. M is the maximum (circumferential segment plus tongue).
Examples
C2M5
Example: C 2 cm, M 5 cm
Example
C 2 cm and M 5 cm (C plus a distal tongue of 3 cm), reported as C2M5
C0M1
Example: tongue only
Example
A 1 cm tongue without a circumferential segment is reported as C0M1
Note: Recognition below 1 cm is unreliable (original RC 0.22).
C2M2
Example: circular, no tongue
Example
A 2 cm circular segment with a relatively straight proximal boundary is reported as C2M2
Sharma 2006, Fig. 3, Original
Oyanagi 2022, Fig. 5, Not original, CC BY
Reference
Original article
Sharma P et al. Gastroenterology 2006;131:1392-1399
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Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.