title: [Usefulness of systematic chromoendoscopy with a double dye staining technique for the detection of dysplasia in patients with premalignant gastric lesions].
abstract: BACKGROUND
  Premalignant gastric lesions have an increased risk to develop gastric cancer.
  
  
  OBJECTIVE
  To evaluate the usefulness of systematic endoscopy that includes chromoendoscopy with a double dye staining technique for the detection of dysplasia in patients with premalignant gastric lesions.
  
  
  METHODS
  This longitudinal, prospective study was performed in patients with gastric atrophy, intestinal metaplasia or dysplasia who were referred for endoscopy less than 6 months after the initial diagnosis. The second endoscopy was performed in three phases: phase 1, exhaustive and systematic review of the mucosa with photographic documentation and biopsies of suspicious areas; phase 2, chromoendoscopy with a double dye staining technique using acetic acid 1.2% and indigo carmine 0.5%; phase 3, topographic mapping and random biopsies.
  
  
  RESULTS
  A total of 50 patients were included. Nine (18%) had atrophic gastritis, 38 (76%) had intestinal metaplasia, and 3 (6%) had low-grade dysplasia. Systematic endoscopy with chromoendoscopy using a double dye staining technique detected more patients with dysplasia (9 versus 3, p<.05), and a larger number of biopsies with the diagnosis of dysplasia were obtained. This occurred for visible (6 vs. 0, p<.05) and non-visible lesions (6 vs. 3, p=NS). In one patient, initial low-grade dysplasia was not detected again in the systematic endoscopy, giving a global endoscopic performance for the detection of lesions of 92%.
  
  
  CONCLUSIONS
  Patients with premalignant gastric lesions have synchronous lesions with greater histological severity, which are detected when systematic endoscopy is conducted with indigo carmine dye added to acetic acid.
authors.affiliation: Hospital Regional Lambayeque, Perú
authors.forename: Víctor
authors.initials: V
authors.lastname: Yep-Gamarra
authors.affiliation: Dirección de investigación del Hospital Regional de Lambayeque, Facultad de Medicina, Universidad San Martín de Porres-Filial Norte. Perú
authors.forename: Cristian
authors.initials: C
authors.lastname: Díaz-Vélez
authors.affiliation: Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona.
authors.forename: Isis
authors.initials: I
authors.lastname: Araujo
authors.affiliation: Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona.
authors.forename: Àngels
authors.initials: À
authors.lastname: Ginès
authors.affiliation: Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, Universitat de Barcelona. Electronic address: mgfernan@clinic.ub.es.
authors.forename: Gloria
authors.initials: G
authors.lastname: Fernández-Esparrach
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005753:Gastric Mucosa / Q000000981:diagnostic imaging; D006801:Humans; D007203:Indigo Carmine; D008137:Longitudinal Studies; D011230:Precancerous Conditions / Q000175:diagnosis*; D011446:Prospective Studies; D013194:Staining and Labeling; D013274:Stomach Neoplasms / Q000175:diagnosis*
chemical_list: D007203:Indigo Carmine
keywords: Atrofia gástrica; Chromoendoscopy; Cribado; Cromoendoscopia; Cáncer gástrico; Displasia; Dysplasia; Gastric atrophy; Gastric cancer; Intestinal metaplasia; Lesiones premalignas; Metaplasia intestinal; Premalignant lesions; Screening