title: Methylene blue staining and endoscopic ultrasound evaluation of Barrett's esophagus with low-grade dysplasia.
abstract: This study was performed to determine if either methylene blue staining or endoscopic ultrasound helped direct biopsies in patients with a history of Barrett's esophagus with low-grade dysplasia. Patients underwent radial endoscopic ultrasound scanning to measure esophageal wall thickness, followed by endoscopy with methylene blue staining and biopsies. Mean esophageal wall thickness for squamous mucosa (2.3 +/- 0.2 mm), nondysplastic Barrett's (2.6 +/- 0.2 mm), and Barrett's with dysplasia (2.9 +/- 0.3 mm) were similar. With staining, Barrett's mucosa stained blue more often than gastric epithelium (68% vs 15%, respectively; P < 0.001). The sensitivity and specificity for strong staining detecting Barrett's were 68% and 85%, respectively. Barrett's with low-grade dysplasia stained blue less frequently (52%) than nondysplastic Barrett's (74%; P < 0.05), but the positive predictive value for poor staining indicating dysplasia was 41%. Endoscopic ultrasound was not helpful in directing biopsies in these patients. The utility of methylene blue for detecting dysplasia needs further investigation.
authors.affiliation: Department of Medicine, Vanderbilt University and Nashville Veteran's Administration Medical Center, Tennessee, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Gangarosa
authors.forename: S
authors.initials: S
authors.lastname: Halter
authors.forename: H
authors.initials: H
authors.lastname: Mertz
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000000981:diagnostic imaging; D019160:Endosonography; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013194:Staining and Labeling
chemical_list: D008751:Methylene Blue