Structures of the normal esophagus and Barrett?s esophagus

Takubo, Kaiyo; Arai, Tomio; Sawabe, Motoji; Miyashita, Masao; Sumii, Koji; Iwakiri, Katsuhiko; Mafune, Ken–ichi

doi:10.1007/s10388-003-0004-y

Cited by 43 publications

(53 citation statements)

References 49 publications

(45 reference statements)

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“…Bombeck et al [19] reported that, in 21 autopsy cases, this distance ranged from 5 to 21 (mean 11) mm, whereas we reported a range of 0 (14 cases) to 10 (mean 3) mm in 50 Japanese cases [9]. In the latter study, the EGJ was defined as the line between the angles of the opened esophagus and the greater curvature of the stomach.…”

Section: Endoscopic Definition Of the Egjmentioning

confidence: 99%

“…In Japan, however, the EGJ is defined endoscopically as the lower limit of the palisade vessels [8,9,10,11,12]. This definition was endorsed by the Japan Esophageal Society in 2000 [8].…”

Section: Endoscopic Definition Of the Egjmentioning

confidence: 99%

“…Furthermore, it has been reported that palisade vessels are not always evident in Western patients. In particular, US and European authors have reported that palisade vessels cannot always be observed upon endoscopy in patients with minimal-change esophagitis [9], characterized endoscopically by a mucosal cloudy whiteness and redness at deep inspiration [14,15], gastroesophageal reflux disease (GERD), CLE, and BE. In such cases in Japan, proton pump inhibitor therapy is recommended before endoscopic examination to reveal the presence of palisade vessels.…”

Section: Endoscopic Definition Of the Egjmentioning

confidence: 99%

“…There are large differences between North American, European and Japanese pathologists with regard to the criteria used for histologic diagnosis of dysplasia (intraepithelial neoplasia) and adenocarcinoma without clear invasion into the lamina propria of the esophagus [9,49], stomach (fig. 5, 6) and duodenum.…”

Section: Mucosal Adenocarcinoma and High-grade Dysplasia In Cle Be mentioning

confidence: 99%

“…Histologic photographs labelled as high-grade dysplasia and some as low-grade dysplasia in textbooks [52,53] of surgical pathology published in North America and Europe would be diagnosed as clearcut cases of well to moderately differentiated tubular adenocarcinoma with or without stromal invasion by Japanese pathologists [9], and also by some experienced German pathologists. Fibrosis, small glands of adenocarcinoma and small nests consisting of a few cancer cells are considered to be evidence of stromal invasion (fig.…”

Section: Mucosal Adenocarcinoma and High-grade Dysplasia In Cle Be mentioning

confidence: 99%

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Differences in the Definitions Used for Esophageal and Gastric Diseases in Different Countries

Takubo

Aida²,

Sawabe³

et al. 2009

Digestion

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Background: Definitions and opinions in the field of gastroenterology vary widely in different countries. Methods: Here we discuss four such important differences: the definition of the esophagogastric junction (EGJ), the possible precursor of Barrett’s adenocarcinoma, the definition of Barrett’s esophagus (BE), and the histologic criteria for mucosal adenocarcinoma. In addition, we consider which definitions and opinions might be valid and practical. Results: There are two different endoscopic definitions of the EGJ. Our research on German subjects has indicated that many small Barrett’s adenocarcinomas may arise not in the intestinal-type but in the cardiac-type mucosa. If an area of columnar-lined esophagus (CLE) is only partially involved by intestinal metaplasia, then the latter cannot always be demonstrated in biopsy specimens. Therefore, we do not think that a definition of BE as CLE with histologic intestinal metaplasia is practical. Data from the literature have shown that many cases of high-grade dysplasia (HGD) progress to carcinoma within a very short time, and in most such cases the carcinoma has been underdiagnosed in biopsy specimens as HGD. Conclusion: With regard to the definitions and opinions, an exchange of views between gastroenterologists in North America, Europe, and Japan would be desirable.

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Section: Endoscopic Definition Of the Egjmentioning

confidence: 99%

“…In Japan, however, the EGJ is defined endoscopically as the lower limit of the palisade vessels [8,9,10,11,12]. This definition was endorsed by the Japan Esophageal Society in 2000 [8].…”

Section: Endoscopic Definition Of the Egjmentioning

confidence: 99%