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Prague System

Printed From: Barrett's Support Forum
Category: Barrett's Support Forum
Forum Name: Barrett's Oesophagus
Forum Discription: Your Questions about Barrett's Oesophagus
Printed Date: 30 May 2020 at 9:44am

Topic: Prague System
Posted By: andyrwhite
Subject: Prague System
Date Posted: 30 Jan 2019 at 11:39am
Just had my surveillance Endoscopy with a Prague score of C43M1. Although I have googled it still don't fully understand what exactly this measures. Can anybody enlighten me in simple terms. Thanks.

Posted By: chrisrob
Date Posted: 01 Feb 2019 at 11:04am
The Prague classification defines the size of your Barrett's segment using a c and m notation.

The first figure shows the depth of a circumferential ring and the second the maximum extent of any tongues.

Unless you've mistyped it, someone has made an error with your recording. c43m1 would mean you had a circumferential ring of 43 cm (which would be almost twice the length of the whole oesophagus) but that the maximum length of any tongue was only 1cm. (Obviously this cannot be less than the c figure.)

Usually one would expect to see something like c2m3 meaning a circumferential ring of 2cm with tongues stretching to 3cm, So, sorry, I cannot suggest what size you Barrett's is.
You may get a clue if you know how many biopsies were taken. The Seattle protocol calls for 4 biopsies (taken quadrantically) every 2 cm over the suspect length. (Needless to say, if you are a giant and have an excessively long oesophagus with 43cm of suspected Barrett's, this would have called for 88 biopsies and would have probably taken about an hour to collect!)

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Posted By: andyrwhite
Date Posted: 01 Feb 2019 at 12:05pm
Thanks Chris for clarifying. Just noticed on the report it states ' Apparent mucosal junction at 43cm from the incisors' so they appear to have used this figure in error for the Circumference figure.

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