Barrett’s esophagus in Japanese patients: its prevalence, form, and elongation

Okita, Koichi; Amano, Yuji; Takahashi, Yoshiko; Mishima, Yuko; Moriyama, Nobuyuki; Ishimura, Norihisa; Ishihara, Shunji; Kinoshita, Yoshikazu

doi:10.1007/s00535-008-2261-y

Cited by 65 publications

(104 citation statements)

References 49 publications

(47 reference statements)

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“…On the other hand, in a study conducted in Japan, the rate of patients that were endoscopically diagnosed with BE was reported to be 37.6%. However, a problem in this study arises from the fact that the authors defined the esophagogastric junction as the area where the esophageal palisade vessels ended (44).…”

Section: The Epidemiology Of Gerd Complications In Turkey and Around mentioning

confidence: 99%

How is the gastroesophageal reflux disease prevalence, incidence, and frequency of complications (stricture/esophagitis/Barrett’s esophagus/ carcinoma) in Turkey compared to other geographical regions globally?

Bor

Yüksel

2017

Turk J Gastroenterol

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Although many studies are conducted on gastroesophageal reflux disease (GERD) and its complications, the questionnaires and reflux definitions used in the studies are different. Mayo, GERD-Q, DIGEST-Q, RDQ, and various other questionnaires that were created and have been used in the studies. The GERD definition that is mostly accepted around the world is the presence of the complaints of heartburn and/or regurgitation at least once a week. However, many different definitions, such as the presence of heartburn and/or regurgitation at least twice a week or at least once a year (if once a week, "frequent"; if once a year, "rare") and the presence of heartburn and/or regurgitation without considering the frequency and severity, were all used in the studies. Therefore, it is quite difficult to obtain a single datum by collecting these studies. However, studies including all questionnaires and reflux definitions were considered while collecting this data.Another problem encountered while performing epidemiological scanning of GERD is that when the world was separated into two parts as the East and the West, some countries that were different from each other were included in the same group (such as Iran-China and Germany-Brazil). Even though continents are considered for this separation, countries that do not resemble each other from any perspective, such as Iran and China, were included in the same group. Therefore, groups must be formed according to the higher number of ethnic distributions. There are also regional epidemiological differences even in the same country. Moreover, there is no term equivalent to heartburn and regurgitation in some Eastern languages.Turkey is geographically located in the middle of the Eastern and Western countries and the epidemiology of GERD and its complications is similar to both geographical groups (Figure 1). In the Eastern countries, the prevalence of GERD is lower and regurgitation is predominant. On the other hand, in the Western countries, the prevalence of GERD is higher and heartburn is predominant. Considering the complications, erosive esophagitis, Barrett's esophagus, and associated esophageal adenocarcinoma are seen in the Western countries more commonly.In GERD epidemiological studies performed in Turkey, the Mayo questionnaire was mostly used (1, 2). The GERD-Q form was used in one study (3). The studies in which the Mayo questionnaire was used, found the prevalence of GERD as 20% (1), 19.3% (2), 12.5% (4), and 22.8% (5,6), respectively. In the study using the other question form, the prevalence of GERD was 24.7% (3). When 5 studies were evaluated cumulatively, the prevalence was calculated to be 23%. It was observed that regurgitation was predominant in all of the studies. In the cumulative evaluation, the rate of prevalence was 23% for regurgitation and 19% for heartburn.While the date of the publications on the epidemiology of GERD goes back to the 2000s in the countries to the east of Turkey, the first articles on this subject were written in 1990s in the Western cou...

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Section: The Epidemiology Of Gerd Complications In Turkey and Around mentioning

confidence: 99%

How is the gastroesophageal reflux disease prevalence, incidence, and frequency of complications (stricture/esophagitis/Barrett’s esophagus/ carcinoma) in Turkey compared to other geographical regions globally?

Bor

Yüksel

2017

Turk J Gastroenterol

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“…This inverse relationship may reflect the high prevalence of H. pylori infection in Japan and the low prevalence in western countries [24,39,40] . Another notable epidemiological difference between these regions is the length of BE; that is, SSBE is common in Japan but LSBE is more prevalent in western countries [27,28,30,31] . The underlying reasons for this difference are not currently known.…”

Section: Variables Associated With Dysplasia In Sce-type Bementioning

confidence: 99%

“…Cag-A positive H. pylori infection is strongly associated with a reduced risk of esophageal adenocarcinoma, and the association is independent of gastric atrophy, suggesting the involvement of a mechanism other than reduced acidic gastric reflux [24][25][26] . In Japan, the prevalence of H. pylori is declining and it can be easily eradicated; however, it remains uncertain whether the incidence of BE will increase or decrease as a consequence of the low prevalence of H. pylori infection [27,28] . BE is characterized by three types of columnar epithelium, namely, cardiac type (junctional type), fundic type, and intestinal metaplasia type [specialized columnar epithelium type (SCE) type].…”

Section: Introductionmentioning

confidence: 99%

“…BE is classified as either long-segment type (length ≥ 3 cm) or short-segment type (length < 3 cm). In western countries, long-segment Barrett's esophagus (LSBE) is more prevalent, while short-segment Barrett's esophagus (SSBE) is more common, and the incidence of adenocarcinoma arising from SSBE is steadily increasing in Japan [27,28,[31][32][33] . Several studies have shown that most patients with BE do not progress to cancer, although some do [1][2][3]29,30] .…”

Section: Introductionmentioning

confidence: 99%

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Risk factors associated with Barrett’s epithelial dysplasia

Fujita

Nakamura

Kasashima

et al. 2014

WJG

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AIM:To elucidate risk factors associated with dysplasia of short-segment Barrett's esophagus (BE). METHODS:A total of 151 BE patients who underwent endoscopic examination from 2004 to 2008 in Aoyama Hospital, Tokyo Women's Medical University, Japan and whose diagnosis was confirmed from biopsy specimens were enrolled in the study. BE was diagnosed based on endoscopic findings of gastric-appearing mucosa or apparent columnar-lined esophagus proximal to the esophagogastric junction. Dysplasia was classified into three grades -mild, moderate and severe -according to the guidelines of the Vienna Classification System for gastrointestinal epithelial neoplasia. Anthropometric and biochemical data were analyzed to identify risk factors for BE dysplasia. The prevalence of Helicobacter pylori (H. pylori ) infection and the expression of p53 by immunohistological staining were also investigated. RESULTS:Histological examination classified patients into three types: specialized columnar epithelium (SCE) (n = 65); junctional (n = 38); and gastric fundic (n = 48). The incidence of dysplasia or adenocarcinoma from BE of the SCE type was significantly higher than that of the other two types (P < 0.01). The univariate analysis revealed that sex, H. pylori infection, body weight, p53 overexpression, and low diastolic blood pressure (BP) were associated with BE dysplasia. In contrast, body mass index, waist circumference, metabolic syndrome complications, and variables related to glucose or lipid metabolism were not associated with dysplasia. Multivariate logistic analysis showed that overexpression of p53 [odds ratio (OR) = 13.1, P = 0.004], H. pylori infection (OR = 0.19, P = 0.066), and diastolic BP (OR = 0.87, P = 0.021) were independent risk factors for epithelial dysplasia in BE patients with the SCE type. CONCLUSION:Overexpression of p53 is a risk factor for dysplasia of BE, however, H. pylori infection and diastolic BP inversely associated with BE dysplasia might be protective.

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“…9 However, as GERD is gradually increasing in Asia, 10 the prevalence of BE may also increase. 11 Most BE in Asia is short-segment BE (SSBE), which also has malignant potential. Endoscopic surveillance for BE may already be required in some Asian countries, including Japan, and some investigators have reported surveying methods for SSBE with special endoscopic techniques such as chromoendoscopy or image-enhanced endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Definition of Esophagogastric Junction for Diagnosis of Barrett's Esophagus: Importance of Systematic Education and Training

Ishimura

Amano

Kinoshita

2009

Digestive Endoscopy

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The diagnosis of Barrett's esophagus (BE) requires an accurate recognition of the columnar-lined esophagus at endoscopy. However, a universally accepted standardized endoscopic grading system of BE was lacking prior to the development of the Prague 'circumferential and maximal' criteria. In this system, the landmark for the esophagogastric junction (EGJ) is the proximal end of the gastric folds, not the distal end of the palisade vessels, which are used to endoscopically identify the EGJ in Japan. Although the circumferential and maximal criteria are clinically relevant, an important shortcoming of this system may be failure to identify short-segment BE, a lesion that is found frequently in the Japanese. To compare the diagnostic yield for BE when using the palisade vessels versus gastric folds as a landmark for the EGJ, we evaluated interobserver diagnostic concordance. The endoscopic identification of the EGJ using both landmarks resulted in unacceptably low kappa coefficients of reliability. However, there was a statistically significant improvement after the participants were thoroughly trained in identification of the EGJ during the endoscopic study. Although it remains controversial which landmark is better for the endoscopic diagnosis of BE, it is important to systematically educate and train endoscopists in order to improve diagnostic consistency in patients with BE.

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Barrett’s esophagus in Japanese patients: its prevalence, form, and elongation

Abstract: Positive predictors for the extension of SSBE were presence of hiatal hernia and reflux symptoms, but not age.

Cited by 65 publications

References 49 publications

How is the gastroesophageal reflux disease prevalence, incidence, and frequency of complications (stricture/esophagitis/Barrett’s esophagus/ carcinoma) in Turkey compared to other geographical regions globally?

How is the gastroesophageal reflux disease prevalence, incidence, and frequency of complications (stricture/esophagitis/Barrett’s esophagus/ carcinoma) in Turkey compared to other geographical regions globally?

Risk factors associated with Barrett’s epithelial dysplasia

Endoscopic Definition of Esophagogastric Junction for Diagnosis of Barrett's Esophagus: Importance of Systematic Education and Training

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