BACKGROUND AND AIM: The standard for classifying Barrett's metaplasia on endoscopy, the Prague C_M criteria, ignore all islands of metaplastic-appearing tissue. The aim of the present study was to measure the prevalence of columnar islands, quantify their impact on metaplasia extent, and determine if they harbor advanced @entity1141 . METHODS: Data from two prospective @entity1 cohorts were retrospectively analyzed. They included adults who underwent upper endoscopy to evaluate for @entity354 ( @entity354 ), @entity355 ( @entity355 ), @entity1141 , or @entity420 between 2003-2012 at tertiary care centers in the United States and Germany. The @entity355 pattern, location, and pathology were examined. The extent of @entity355 as defined by the Prague criteria (disregarding the location of islands) was compared to the complete maximal extent of @entity355 (incorporating the location of islands). RESULTS: 555 @entity1 underwent endoscopy (mean 60.1   years, 67.2% male, 91.9% white). 191 (34.4%) showed metaplastic-appearing mucosa in islands. Endoscopically, in 101 (52.9%) cases, islands were proximal to the farthest segment of @entity355 as defined by the Prague M location. Histologically, IM was confirmed in 60 (58.8%) of the 102 EGDs where islands were biopsied. In 41 (40.2%) cases, the histologically-confirmed @entity355 islands extended farther than the maximal segment based on the Prague criteria. Pathology from biopsies of islands either changed the diagnosis or worsened the @entity355 grade in 16 (15.7%) of 102 @entity1 . CONCLUSIONS: Columnar islands are commonly seen on EGD. The Prague C_M criteria may underestimate the maximal extent of @entity355 and overlook the area of highest @entity1141 grade.

Columnar Islands in Barrett's Esophagus: Do They Impact Prague C_M Criteria and XXXX Grade?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity355 :: ('MESH:D001471', 'Disease') :: ['BE dysplasia', 'BE', "Barrett's esophagus"] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastroesophageal reflux disease', 'GERD'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity1141 :: (MESH:C535662,Disease) :: ['Dysplasia']
