{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:02:37Z","timestamp":1790949757292,"version":"4.1.0"},"reference-count":25,"publisher":"BMJ","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The incidence of distal oesophageal adenocarcinoma is rising, with chronic reflux and Barrett\u2019s oesophagus being considered risk factors. Reliable detection of Barrett\u2019s oesophagus during upper endoscopy is therefore mandatory but requires both endoscopy and histology for confirmation. Appropriate management of patients with endoscopic suspicion but negative on histology, or vice versa, or of patients with no endoscopic suspicion but with a biopsy diagnosis of intestinal metaplasia at the gastro-oesophageal junction, has not yet been studied prospectively.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Patients and methods:<\/jats:bold>\n                    In a prospective multicentre study, 929 patients (51% male, mean age 50 years) referred for upper gastrointestinal endoscopy were included; 59% had reflux symptoms. The endoscopic aspect of the Z line and any suspicion of Barrett\u2019s oesophagus were noted, and biopsies were taken in all patients from the Z line (n\u200a=\u200a4), gastric cardia (n\u200a=\u200a2), and body and antrum (n\u200a=\u200a2 each). Biopsies positive for specialised intestinal metaplasia (SIM) were reviewed by a reference pathologist for a final Barrett\u2019s oesophagus diagnosis. All patients with endoscopic and\/or histological suspicion of Barrett\u2019s oesophagus were invited for a follow up endoscopy; the remaining cases (no endoscopic or histological suspicion of Barrett\u2019s oesophagus) were followed clinically.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Of 235 patients positive for Barrett\u2019s oesophagus on endoscopy and\/or histology, 63% agreed to undergo repeat endoscopy (mean follow up period 30.5 months). 46% of patients with an endoscopic Barrett\u2019s oesophagus diagnosis but no histological confirmation (group A) showed the same distribution, a further 42% did not have Barrett\u2019s oesophagus, and 11% had confirmed Barrett\u2019s oesophagus on both endoscopy and biopsy on follow up. In the group with a histological Barrett\u2019s oesophagus diagnosis but negative on initial endoscopy (group B), follow up showed the same in 26% whereas 46% had no Barrett\u2019s oesophagus, and confirmed Barrett\u2019s oesophagus (endoscopy plus histology) was diagnosed in 17%. Of the study population, 16 patients had Barrett\u2019s oesophagus on initial endoscopy confirmed by histology which remained constant in 70% at follow up (group C). Of the remaining patients without an initial Barrett\u2019s oesophagus diagnosis on either endoscopy or histology (group D) and only clinical follow up (mean follow up period 38 months), one confirmed Barrett\u2019s oesophagus case was found among 100 patients re-endoscoped outside of the study protocol. However, no single case of dysplasia or cancer of the distal oesophagus was detected in any patient during the study period.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Even in a specialised gastroenterology setting, reproducibility of presumptive endoscopic or histological diagnoses of Barrett\u2019s oesophagus at follow up were poor. Only 10\u201320% of cases with either endoscopic or histological suspicion of Barrett\u2019s oesophagus had established Barrett\u2019s oesophagus after 2.5 years of follow up. The risk of dysplasia in this population was very low and hence meticulous follow up may not be required.\n                  <\/jats:p>","DOI":"10.1136\/gut.2003.036822","type":"journal-article","created":{"date-parts":[[2004,9,10]],"date-time":"2004-09-10T20:09:07Z","timestamp":1094846947000},"page":"1402-1407","source":"Crossref","is-referenced-by-count":61,"title":["The Munich Barrett follow up study: suspicion of Barrett\u2019s oesophagus based on either endoscopy or histology only\u2014what is the clinical 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