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. 2021 Mar 1;60(5):667-674.
doi: 10.2169/internalmedicine.5676-20. Epub 2020 Sep 30.

Prevalence of Barrett's Epithelium Shown by Endoscopic Observations with Linked Color Imaging in Subjects with Different H. pylori Infection Statuses

Kyoichi Adachi  1 , Norihisa Ishimura  2 , Kanako Kishi  1 , Takumi Notsu  1 , Tomoko Mishiro  1 , Kazunari Sota  1 , Shunji Ishihara  2
Affiliations

Prevalence of Barrett's Epithelium Shown by Endoscopic Observations with Linked Color Imaging in Subjects with Different H. pylori Infection Statuses

Kyoichi Adachi et al. Intern Med. .

Abstract

Objective This study was conducted to clarify the prevalence of short segment Barrett's esophagus (SSBE) using endoscopic observations with linked color imaging (LCI). In addition, the relationship between the presence of Barrett's epithelium (BE) and the status of H. pylori infection was investigated. Methods The study subjects were 3,353 individuals (2,186 men, 1,167 women; mean age 55.2±9.4 years old) whose status of H. pylori infection had been determined. An endoscopic observation using LCI was performed to examine the distal margin of palisade vessels and confirm the area of BE. The prevalence of BE ≥5 mm in length was investigated. Results BE was diagnosed in 1,884 (56.2%) subjects, with lengths of <10, 10-19, 20-29, and ≥30 mm found in 1,005, 851, 27, and 1, respectively. Its prevalence in H. pylori-negative, H. pylori-positive, and post-eradicated subjects was 41.7%, 64.4%, and 69.9%, respectively (p<0.001). The duration since successful eradication of H. pylori did not affect the prevalence of BE. The degree of gastric mucosal atrophy was higher in cases with BE (p<0.001), although negativity for H. pylori infection and mild gastric mucosal atrophy were significant factors for the development of longer BE. Conclusion A high prevalence of SSBE was noted when LCI was used to determine the area of BE, as the distal end of the palisade vessels was easily visualized. Negativity for H. pylori infection and mild gastric mucosal atrophy were not correlated with SSBE prevalence.

Keywords: Barrett's esophagus; Helicobacter pylori; LCI; SSBE; prevalence.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Protocol for subject selection.
Figure 2.
Figure 2.
Representative endoscopic findings of short segment Barrett’s esophagus (SSBE) in subject without H. pylori infection [a: white light imaging (WLI), b: linked color imaging (LCI)]. The presence of palisade vessels in the area of columnar lined epithelium was shown, and these vessels were revealed to be sequentially connected to the palisade vessels in the area of squamous epithelium, which was easily visualized by LCI. SSBE length was classified as 10-19 mm in this case.
Figure 3.
Figure 3.
Representative endoscopic findings of short segment Barrett’s esophagus (SSBE) in subject without H. pylori infection [a: white light imaging (WLI), b: linked color imaging (LCI)]. The presence of palisade vessels in the area of columnar lined epithelium was easily diagnosed by LCI, although it was not easily recognized by WLI. The SSBE length was classified as <10 mm in this case.
Figure 4.
Figure 4.
Prevalence of Barrett’s epithelium in subjects divided by the duration since the eradication of H. pylori.
See this image and copyright information in PMC

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