Prague Barrett’s C&M Criteria
The Prague C&M criteria for grading of Barrett’s esophagus was so named because it was first presented by the IWGCO at the 2004 United European Gastroenterology Week meeting in Prague, Czech Republic. These are the first formally researched and validated methods for recognition and description of extent of endoscopically suspected esophageal columnar metaplasia.
An original paper (Sharma et al Gastroenterology (2006) 131:1392-1399) presents the criteria and their validation.
The simple, easily memorised criteria are explained visually, step-by-step in a downloadable graphic which is suitable for display in endoscopy procedure rooms.
The key steps are:
- Identify the gastro-esophageal junction as at the tops of the gastric mucosal folds
- If hiatus hernia is present, do not mistake the diaphragmatic hiatal impression for the gastro-esophageal junction
- For circumferential columnar-appearing mucosa above the gastro-esophageal junction define this extent in centimetres above the gastro- esophageal junction:
– report as the C value
- For any tongue-like areas of columnar-appearing mucosa, measure the Maximum extent in centimetres above the gastro-esophageal junction:
– report as the M value
The IWGCO has produced a DVD which presents background to the C&M Criteria, including an annotated video clip that explains the Criteria, and endoscopic video clips designed to build experience in the use of the Criteria.
More information related to this project can be found on the BORN page.