Endoscopic findings around gastroesophageal junction in Korea

초록

Background/Aim There are several classification systems to describe endoscopic findings around the gastroesophageal junction (GEJ), such as the Z-line appearance (ZAP) and the gastroesophageal flap valve grading system (GEFV) and Los Angeles classification of reflux esophagitis (LA). The aim of this study was to elucidate the distribution of endoscopic findings around GEJ in Korean patients. Methods We analyzed the endoscopic data from 2450 patients who underwent routine diagnostic upper endoscopy for various reasons in a single hospital. Results With ZAP classification, ZAP 0 (n =873), ZAP 1 (n =1254), ZAP 2 (n =292) and ZAP 3 (n =1), respectively. With GEFV grading, GEFV1 (n =635), GEFV2 (n =1166), GEFV3 (n =347) and GEFV4 (n =234). 145 cases were classified as LA-A, 85 as -B, 11 as -C and 1 as-D, respectively. About hiatal hernia, 150 cases had short segment hiatal hernia (<2.0 cm) and 89 cases classic hiatal hernia (≥2.0 cm). An increased prevalence of reflux esophagitis, hiatal hernia and columnar lined esophagus (CLE) was correlated with an increased grade of ZAP and GEFV. Increased ZAP and GEFV grade was correlated with increased grade of RE and increased length of HH and CLE. Man was likely to have more increased ZAP and GEFV grade than woman (p <0.05). Increased ZAP grade was also correlated with an increased GEFV grade (p <0.05). Conclusion This is the first study in Korea that describe the endoscopic findings of GEJ by ZAP and GEFV classification, the association with each other and reflux esophagitis as well.