Criteria

Histological criteria

  • Barrett's oesophagus is defined histologically as areas of columnar-lined epithelium in the oesophagus cephalad to the gastro-oesophageal junction. Histological assessment by experienced pathologists is the standard method of pathological diagnosis of Barrett’s oesophagus with and without dysplasia.[7] Investigations into increasing accuracy with special pathological staining, such as cytokeratin stain and biomarkers, have generally been disappointing.[15][42]

  • Areas of carcinoma in situ or invasive carcinoma can exist in Barrett's oesophagus and are frequently referred to as Barrett's cancers.[1][4][43]

Length and dysplasia

Maximal length[44]

  • Short-segment: <3 cm

  • Long-segment: 3 cm or longer.

Degree of dysplasia[4]

  • No dysplasia

  • Indefinite for dysplasia

  • Low-grade dysplasia

  • High-grade dysplasia.

Prague C&M classification[45]

A detailed and reproducible description of the extent of Barrett's oesophagus visualised during endoscopy is necessary.[7] Current guidelines recommend using the Prague C&M classification, which uses assessment of the circumferential (C) and maximal (M) extent of the endoscopically visualised segment of Barrett's oesophagus.[7]​[32]​​

In addition, the location of the oesophagogastric junction and the diaphragmatic hiatus should be documented in every endoscopy report.

A circumferential segment of Barrett's oesophagus of 2 cm in length and tongues of intestinal metaplasia extending an additional 3 cm proximally would be classified as C2M5.

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