P235 Comparison of segment length in columnar lined oesophagus between South Asian and white Caucasian populations using prague’s criteria (LUMBAEE)

Introduction and Aim

Barrett’s oesophagus (BO), a precursor lesion of adenocarcinoma oesophagus (ACO)¹ is a global disease and there are differences in relation to epidemiology, risk factors and progression to ACO when compared in different ethnicities. Additionally, BO is divided into short (SBO) and long segment (LBO) based on cut off mark of 3 cm. The length of BO per se is directly related to progression to ACO.² The aim of the current study was to assess if the length of BO segment is different when compared between White British (WBP) and South Asian populations (SAP).

Method

Using Prague’s Criteria both Circumferential (CBO) and Maximum (MBO) length of BO were measured prospectively. Both CBO and MBO were compared for significance difference in WBP and SAP. Data was not distributed normally (p<0.05) hence presented as median and interquartile range and non-parametric tests were used to assess statistical significance.

Results

The ages of the population (n=249, Females =135 (53%)) ranged from 18 to 95 years (M = 58.2, SD±17.3, IQR = 25–75). There were 221 (88.8%) WBP and 28 (11.2%) SAP in the study population. GOJs were compared, and significant differences were observed in both ethnicity (WBP (Median = 40, n = 221, IQR=38–42) and SAP (Median = 39, n = 28, IQR=38–40), p <0.01). There were 159 (63.9%) cases of SSBO and 90 cases (36.1%) of LSBO in the population (n=249). Significant differences were observed in MBO of WBP (Median = 2, n = 221, IQR=2–3) and SAP (Median = 2, n = 28, IQR=1–2), p =0.01)]. Equally, Significant difference was also noticed in the CBO of WBP (Median = 1, n = 219, IQR=1–2) and SAP (Median = 1, n = 28, IQR=1–1), p <0.01).

Conclusion

Our study shows that SAP have shorter CBO and MBO as compared to WBP and it may partly explain the low progression of ACO in SAP. Granted more prospective research is needed to clarify this point by interpreting this finding in the light of risk factor for BO and ACO i.e., reflux, Body Mass Index, smoking and dietary factors.

References

Reid BJ, et al. Barrett’s oesophagus and oesophageal adenocarcinoma: time for a new synthesis. Nature Reviews.Cancer 2010;10(2):87–101. doi:10.1038/nrc2773 Pohl H, et al. Length of barrett’s oesophagus and cancer risk: implications from a large sample of patients with early oesophageal adenocarcinoma. Gut 2016;65(2):196–201. doi:10.1136/gutjnl-2015-309220