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

Korean J Gastrointest Endosc > Volume 34(5); 2007 > Article

Korean Journal of Gastrointestinal Endoscopy 2007;34(5): 239-243.

Palisading Vessel의 하단과 Z-line의 불일치 비율 및 검사자 간 일치도

정준원·이진혁·최기돈·송호준·김병규·최귀숙·정훈용·김진호

울산대학교 의과대학 서울아산병원 내과학교실

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

Jun-Won Chung, M.D., Gin Hyug Lee, M.D., Kee Don Choi, M.D., Ho June Song, M.D., Benjamin Kim, M.D., Kwi-Sook Choi, M.D., Hwoon-Yong Jung, M.D. and Jin-Ho Kim, M.D.

Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

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. (Korean J Gastrointest Endosc 2007;34:239⁣243)

Key Words: Barrett's esophagus, Esophageal adenocarcinoma, Gastroesophageal junction, Palisading vessel

주요어: 바렛식도, 위식도 경계부, 식도 선암, 책상 혈관