Crystal violet chromoendoscopy with mucosal pit pattern diagnosis is useful for surveillance of short-segment Barrett's esophagus.

Abstract

BACKGROUND:

Because of a rapid increase in the incidence of Barrett's cancer, the appropriate surveillance method for Barrett's esophagus is of interest. Methylene blue chromoendoscopy has been reported to be an effective and inexpensive method to improve biopsy surveillance of Barrett's epithelium. However, the usefulness of this method in short-segment Barrett's esophagus cases is still controversial.

AIMS:

This study was undertaken to evaluate the abilities of crystal violet and methylene blue chromoendoscopy to detect potentially dysplastic Barrett's epithelium in cases with short-segment columnar-appearing epithelium of the esophago-gastric junction.

PATIENTS AND METHODS:

Four hundred patients with endoscopically suspected short-segment Barrett's esophagus were enrolled and randomly assigned to receive chromoendoscopy with 0.05% crystal violet, 0.1% crystal violet, 0.5% methylene blue, or 1.0% methylene blue. During crystal violet and methylene blue chromoendoscopy, biopsy specimens were obtained from stained and unstained columnar-appearing epithelium of the esophago-gastric junction, and the detection rates of Barrett's epithelium were evaluated. The value of pit pattern diagnosis was also evaluated as a possible way to detect dysplastic Barrett's epithelium.

RESULTS:

Chromoendoscopy with 0.05% crystal violet detected histologically confirmed Barrett's epithelium with the highest sensitivity (89.2%) and specificity (85.7%). Crystal violet clearly stained both dysplastic and nondysplastic Barrett's epithelia and made the surface pit pattern easy to observe without using magnifying endoscopy.

CONCLUSIONS:

The combination of crystal violet chromoendoscopy and pit pattern diagnosis is considered to be useful for the surveillance of short-segment Barrett's esophagus.

• Authors: Yuji Amano, Yoshinori Kushiyama, Shunji Ishihara, Takafumi Yuki, Youichi Miyaoka, Nagisa Yoshino, Norihisa Ishimura, Hirofumi Fujishiro, Kyoichi Adachi, Riruke Maruyama, Mohammad Azharul Karim Rumi, Yoshikazu Kinoshita
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 100 Issue 1 Pg. 21-6 (Jan 2005) ISSN: 0002-9270 [Print] United States
• PMID: 15654776 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Coloring Agents
• Gentian Violet
• Methylene Blue

Topics

• Adult
• Aged
• Aged, 80 and over
• Barrett Esophagus (pathology)
• Coloring Agents
• Esophagoscopy (methods)
• Female
• Gentian Violet
• Humans
• Male
• Mass Screening (methods)
• Methylene Blue
• Middle Aged
• Mucous Membrane (pathology)
• Sensitivity and Specificity