Barrett’s Esophagus is a condition where the lining of the esophagus changes due to chronic acid reflux. This change in the lining of the esophagus is called metaplasia, and it can lead to an increased risk of developing esophageal cancer.
To diagnose Barrett’s Esophagus, doctors use a set of criteria known as the Prague Criteria. The Prague Criteria is a system used to classify and stage Barrett’s Esophagus based on endoscopic findings.
The Prague Criteria consists of two parts – the circumferential extent (C) and maximum extent (M). The circumferential extent refers to the percentage of the esophageal circumference that is affected by Barrett’s Esophagus, while the maximum extent refers to how far up the esophagus the metaplastic tissue extends.
The circumferential extent is categorized into four grades: C0, C1, C2, and C3. C0 means that there is no visible metaplastic tissue in the esophageal lining.
C1 means that less than one-third of the esophageal circumference is affected by metaplastic tissue. C2 means that between one-third and two-thirds of the esophageal circumference is affected. Finally, C3 means that more than two-thirds of the esophageal circumference is affected.
The maximum extent is categorized into four grades as well – M1, M2, M3a, and M3b. M1 means that there are visible patches or tongues of metaplastic tissue less than 3mm in length above the gastroesophageal junction (GEJ).
M2 refers to patches or tongues greater than 3mm in length but not extending completely around the lumen above GEJ. M3a refers to tongues or short segments extending completely around lumen above GEJ while M3b refers to long segments extending completely around lumen above GEJ.
By combining both C and M classifications, doctors can determine the overall severity of Barrett’s Esophagus. For example, a person with C2M2 Barrett’s Esophagus would have between one-third and two-thirds of the esophageal circumference affected by patches greater than 3mm but not extending completely around the lumen above the GEJ.
In conclusion, the Prague Criteria is an important tool used to diagnose and classify Barrett’s Esophagus. It helps doctors determine the extent of metaplastic tissue in the esophagus and its potential risk for developing into cancer. Proper diagnosis and monitoring of this condition can help prevent it from progressing into a more serious illness.