title: The usefulness of chromoendoscopy with methylene blue in Barrett's metaplasia and early esophageal carcinoma.
abstract: BACKGROUND
  Barrett's esophagus is a condition that is premalignant for adenocarcinoma of the esophagus and the esophagogastric junction. Early detection of Barrett's metaplasia and dysplasia is very important to decrease the mortality and morbidity from esophageal adenocarcinoma cancer. This study aimed to evaluate the effectiveness of methylene blue-targeted biopsies in the differential diagnosis of intestinal metaplasia, dysplasia, and superficial esophageal carcinoma.
  
  
  METHODS
  A total of 109 patients (43 women and 66 men; average age, 62.32 +/- 10.61 years; range, 33-82 years) were enrolled for the study. Four groups were designed before endoscopic examinations. The patients for these groups were selected at the conventional endoscopy, and then chromoendoscopy was performed. The esophagus was stained with methylene blue, after which six biopsies were taken from stained and unstained areas.
  
  
  RESULTS
  Conventional and chromoendoscopic assessments were compared with histopathologic examination. The sensitivity of chromoendoscopy for Barrett's epithelium was superior to that of conventional endoscopy (p < 0.05). However, there was no statistical difference between the two methods in the diagnosis of esophagitis or esophageal carcinoma (p > 0.05). Stained biopsies were superior to unstained biopsies in terms of sensitivity for Barrett's epithelium and esophageal carcinoma (p < 0.001).
  
  
  CONCLUSIONS
  Chromoendoscopy is useful for delineating Barrett's epithelium and for indicating the correct location for securing biopsies where dysplasia or early esophageal cancer is suspected.
authors: Department of Gastroenterology, Ankara University, School of Medicine, 39. Cd. Pembe Kosk Apt. 1/4 Cukurambar, Cankaya, 06520, Ankara, Turkey.
authors: N
authors: N
authors: Ormeci
authors: B
authors: B
authors: Savas
authors: S
authors: S
authors: Coban
authors: M
authors: M
authors: Palabiyikoğlu
authors: A
authors: A
authors: Ensari
authors: I
authors: I
authors: Kuzu
authors: N
authors: N
authors: Kursun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000175:diagnosis / Q000473:pathology*; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013194:Staining and Labeling / Q000379:methods
chemical_list: D008751:Methylene Blue
references: Gastrointest Endosc. 1998 Jul;48(1):26-31
references: 9684660
references: Endoscopy. 2004 Jul;36(7):590-4
references: 15243880
references: Int J Epidemiol. 2000 Aug;29(4):645-54
references: 10922340
references: Endoscopy. 2005 Jan;37(1):8-18
references: 15657852
references: Gut. 2004 Aug;53(8):1070-4
references: 15247170
references: Gut. 2003 Jan;52(1):24-7
references: 12477754
references: Dig Dis Sci. 2002 Sep;47(9):2108-11
references: 12353864
references: Gastrointest Endosc. 2001 Sep;54(3):403-9
references: 11522995
references: Gastrointest Endosc. 2001 May;53(6):559-65
references: 11323579
references: Gastroenterol Clin North Am. 2002 Jun;31(2):461-79, ix
references: 12134613
references: Crit Rev Oncol Hematol. 2003 May;46(2):187-206
references: 12711361
references: Endoscopy. 2005 Jun;37(6):583-6
references: 15933935
references: Endoscopy. 2005 Sep;37(9):879-920
references: 16116544
references: Gastroenterology. 2000 Apr;118(4):670-7
references: 10734018
references: Gut. 2005 Mar;54 Suppl 1:i6-12
references: 15711008
references: Gut. 2003 May;52(5):623-8
references: 12692043
references: Gastroenterology. 2004 Jul;127(1):310-30
references: 15236196
references: Scand J Gastroenterol. 1993 Mar;28(3):193-6
references: 8446842
references: Endoscopy. 2001 Nov;33(11):909-16
references: 11668398
references: Endoscopy. 2001 May;33(5):391-400
references: 11396755
references: Dig Dis Sci. 2000 Feb;45(2):225-9
references: 10711429
references: Ann Intern Med. 2003 Feb 4;138(3):176-86
references: 12558356
references: JAMA. 2002 Apr 17;287(15):1972-81
references: 11960540
references: Dig Dis Sci. 2005 Feb;50(2):389-93
references: 15745106
references: Gut. 2001 Mar;48(3):314-9
references: 11171819
references: Gut. 2003 Jan;52(1):28-33
references: 12477755
references: Gastrointest Endosc. 2001 Sep;54(3):289-93
references: 11522967
references: Am J Gastroenterol. 1997 Feb;92(2):212-5
references: 9040193
references: Gastrointest Endosc. 2000 May;51(5):560-8
references: 10805842
references: Lancet. 2003 Aug 2;362(9381):373-4
references: 12907012
references: Endoscopy. 2004 Feb;36(2):103-9
references: 14765307
references: Am J Med. 2001 Dec 3;111 Suppl 8A:130S-136S
references: 11749938
references: Gastroenterology. 2001 Jan;120(1):7-12
references: 11208708
references: Gastroenterology. 2005 Dec;129(6):1825-31
references: 16344051
references: Gastroenterology. 2000 Sep;119(3):677-82
references: 10982761
references: Gastrointest Endosc. 1996 Jul;44(1):1-7
references: 8836709
references: Endoscopy. 1999 May;31(4):325-8
references: 10376462
references: Gastrointest Endosc. 2001 Jan;53(1):47-52
references: 11154488
references: Gastroenterol Clin North Am. 2002 Jun;31(2):441-60
references: 12134612
references: Gastrointest Endosc. 2001 Sep;54(3):294-301
references: 11522968
references: Gastrointest Endosc. 2001 Mar;53(3):333-5
references: 11231393
references: N Engl J Med. 2002 Mar 14;346(11):836-42
references: 11893796
references: Endoscopy. 2002 Aug;34(8):604-10
references: 12173079
references: Gut. 2003 Jan;52(1):18-23
references: 12477753