title: 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.
  
  
  OBJECTIVE
  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.
  
  
  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.affiliation: Department of Gastrointestinal Endoscopy, Shimane University, School of Medicine, 89-1 Enya-cho, Izumo-shi, Shimane 693-8501, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Amano
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kushiyama
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yuki
authors.forename: Youichi
authors.initials: Y
authors.lastname: Miyaoka
authors.forename: Nagisa
authors.initials: N
authors.lastname: Yoshino
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fujishiro
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Adachi
authors.forename: Riruke
authors.initials: R
authors.lastname: Maruyama
authors.forename: Mohammad Azharul Karim
authors.initials: MA
authors.lastname: Rumi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology*; D004396:Coloring Agents; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005840:Gentian Violet; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008751:Methylene Blue; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D012680:Sensitivity and Specificity
chemical_list: D004396:Coloring Agents; D005840:Gentian Violet; D008751:Methylene Blue