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

Kyoichi Adachi1, Norihisa Ishimura2, Kanako Kishi1, Takumi Notsu1, Tomoko Mishiro1, Kazunari Sota1, Shunji Ishihara2

Intern Med. 2020 Sep 30. doi: 10.2169/internalmedicine.5676-20. Online ahead of print.

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.

1 Health Center, Shimane Environment and Health Public Corporation, Japan
2 Second Department of Internal Medicine, Shimane University, Faculty of Medicine, Japan