title: Endoscopic versus histological diagnosis of Barrett's esophagus: a cross-sectional survey.
abstract: BACKGROUND
  Barrett's esophagus is a common pathological condition in patients with gastro-esophageal reflux disease.
  
  
  OBJECTIVE
  The aim of this study was to compare endoscopic diagnosis versus histological confirmation.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Cancer Institute of the Imam Khomeini Hospital.
  
  
  METHODS
  A total of 50 patients with a history of gastro-esophageal reflux were recruited and underwent upper endoscopy at this cross-sectional survey. Four-quadrant biopsy was taken from all suspected areas of intestinal metaplasia. Sections of blocks were stained with Mixed Alcian Blue (PH 2.5)/PAS and haematoxylin-eosin stainings for the diagnosis of intestinal metaplasia (complete vs. incomplete types) and goblet cell / columnar cell / dysplasia, respectively.
  
  
  METHODS
  The presence of Helicobacter pylori was assessed by Giemsa staining.
  
  
  RESULTS
  There were 44 cases of short-segment Barrett's esophagus and 6 of long-segment Barretts esophagus by endoscopy. When examined by histologic examination, 12 patients with short-segment Barrett's esophagus and 4 with long-segment Barrett's esophagus had intestinal metaplasia. Haematoxylin-eosin staining diagnosed 12 cases of intestinal metaplasia, whereas mixed alcian blue/PAS was used to diagnose 16 cases (κ = 80%, p < 0.001). The positive predictive value in the diagnosis of goblet cell metaplasia and columnar cell metaplasia was 32% and 66%, respectively. Helicobacter pylori infection was observed in 10 cases of those with columnar cell metaplasia without goblet cells, while none of the patients with intestinal metaplasia were infected.
  
  
  CONCLUSIONS
  Our findings suggest that biopsy taking is necessary in all patients with gastro-esophageal reflux disease, whose results suggest columnar cell lining in distal esophagus in endoscopy.
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Giti
authors.initials: G
authors.lastname: Irvanloo
authors.forename: Behnaz
authors.initials: B
authors.lastname: Fallahi
authors.forename: Fereshte
authors.initials: F
authors.lastname: Ensani
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Azmi
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Morteza
mesh_terms: D000423:Alcian Blue / Q000737:chemistry; D001471:Barrett Esophagus / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D001706:Biopsy; D003430:Cross-Sectional Studies; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000150:complications / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D010503:Periodic Acid-Schiff Reaction / Q000379:methods; D011237:Predictive Value of Tests
chemical_list: D000423:Alcian Blue