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28 lut 2018 · An irregular Z line is characterized by < 1 cm columnar tongues that extend proximal to the gastroesophageal junction, a finding that has been reported in approximately 10–15% of the population undergoing upper endoscopy [1, 2].
We recommend endoscopists adopt a precise description of irregularity at the SCJ and that BE only be diagnosed when tissue is obtained from the tubular esophagus. Additional study is needed to better define the landmarks at the SCJ and to determine the risk of malignancy in patients with SIM in different parts of the upper gastrointestinal tract.
In the absence of any visible lesions, patients with a Z line demonstrating <1 cm of proximal displacement from the top of the gastric folds should not undergo routine endoscopic biopsies (quality of evidence: low; strength of recommendation: conditional).
Barrett's oesophagus should be endoscopically distinguished from an irregular Z-line, whereby the squamocolumnar junction appears with tongues of columnar epithelium shorter than 1 cm and with no confluent columnar-lined segment.
3 lis 2022 · The Z line is a normal finding but is not seen in every study. An irregular or elevated Z line indicates potential distal esophageal metaplasia / Barrett esophagus, although the actual risk of this finding is debated.
21 maj 2024 · Irregular Z-line, defined as < 1 cm segment of columnar mucosa in distal esophagus, is commonly encountered and frequently biopsied. Consensus guidelines recommend against biopsies of irregular z-line due to low risk of progression to esophageal cancer (EAC).
29 paź 2020 · Biopsies of a normal or irregular z-line are not recommended. If biopsies are sampled from an irregular Z-line, with no clear endoscopic evidence of Barrett’s, they should then be sent to the pathologist as z-line biopsies and not as endoscopically suspected Barrett esophagus (ESEM) biopsy samples.
