Evidence map›Paper›PMID 40159999›Full record

ArticleClinical endoscopy2025

Prevalence of intestinal metaplasia, dysplasia, and esophageal adenocarcinoma in patients with irregular Z-line: a systematic review and meta-analysis.

Vishali Moond, Pradeep Yarra, Mannat Bhatia, Sheza Malik, Vineel Malavarappu, Hassam Ali, Saurabh Chandan, Douglas G Adler, Babu P Mohan

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Article in Clinical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Vishali MoondDepartment of Internal Medicine, Saint Peter's University Hospital/Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Pradeep YarraDepartment of Gastroenterology & Hepatology, Saint Louis University, St. Louis, MO, USA.
Mannat BhatiaDepartment of Internal Medicine, Saint Peter's University Hospital/Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Sheza MalikDepartment of Internal Medicine, Reading Hospital, West Reading, PA, USA.
Vineel MalavarappuCarver College of Medicine, University of Iowa, Iowa City, IA, USA.
Hassam AliDepartment of Gastroenterology, Hepatology & Nutrition, ECU Health Medical Center/Brody School of Medicine, Greenville, NC, USA.
Saurabh ChandanDivision of Gastroenterology & Hepatology, Creighton University School of Medicine, Omaha, NE, USA.
Douglas G AdlerCenter for Advanced Therapeutic Endoscopy, Centura Health, Porter Adventist Hospital, Denver, CO, USA.
Babu P MohanDepartment of Gastroenterology & Hepatology, Orlando Gastroenterology PA, Orlando, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsThe irregular Z-line, defined as a segment of columnar mucosa less than 1 cm in the distal esophagus, is often biopsied despite guidelines advising against it due to a low risk of progression to esophageal adenocarcinoma (EAC). However, the clinical significance of an irregular Z-line remains unclear. This meta-analysis examines the prevalence of Barrett's esophagus, dysplasia, and EAC in patients with an irregular Z-line.

methodsWe searched Medline, Embase, and Scopus databases up to October 2023 for studies on the prevalence of Barrett's esophagus, dysplasia, and EAC in these patients. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics.

resultsNine studies involving 17,637 patients were analyzed. Among those with an irregular Z-line, the prevalence of intestinal metaplasia was 29.4%. In patients with intestinal metaplasia, dysplasia was found in 6.2%, low-grade dysplasia in 5.9%, high-grade dysplasia in 1.6%, and EAC in 1.5%. These rates were higher compared to those without intestinal metaplasia.

conclusionsPatients with an irregular Z-line and intestinal metaplasia may be at higher risk and could benefit from endoscopic surveillance. Further studies are needed to determine the necessity of biopsying irregular Z-lines.

Indexed as

Barrett esophagusEsophagusGuideline adherenceMetaplasiaNeoplasms

Identifiers

PMID40159999
PMCPMC12138366

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.