Area Editoriale
BACKGROUND &AIMS: Barrett's esophagus (BE) is a premalignant condition for esophagealadenocarcinoma, its diagnosis relying initially on recognition of acolumnar-lined distal esophagus. We aimed to develop and validate explicit,consensus-driven criteria for the endoscopic diagnosis and grading of BE.METHODS: An international working group agreed on criteria and developedmaterials for their formal evaluation using video-endoscopic recordingsgathered in a standardized manner in 29 patients. The criteria includedassessment of the circumferential (C) and maximum (M) extent of theendoscopically visualized BE segment as well as endoscopic landmarks. Therecordings were scored according to these criteria by a separate internationalpanel of 29 endoscopists. RESULTS: The Prague C & M Criteria give explicitguidance on the endoscopic recognition of BE and grading of its extent. Theoverall reliability coefficients (RC) for the assessment of the C & Mextent of the endoscopic BE segment above the gastroesophageal junction were0.95 and 0.94, respectively. The rates of exact agreement (for C & Mvalues) for pairwise comparisons of individual patient values were 53% and 38%,respectively, whereas the values for agreement within a 2-cm interval were 97%and 95%, respectively. The overall RC for endoscopic recognition of BE >/=1cm was 0.72, whereas for BE <1 cm, it was 0.22. The RCs for recognizing thelocation of the gastroesophageal junction and the diaphragmatic hiatus were0.88 and 0.85, respectively. CONCLUSIONS: The Prague C & M Criteria havehigh overall validity for the endoscopic assessment of visualized BE lengths. Leggil'articolo