Methylene blue staining for intestinal metaplasia of the gastric cardia with follow-up for dysplasia
Background: Previous studies by our group have identified a 23% prevalence of intestinal metaplasia involving the gastric cardia in patients undergoing elective esophagogastroduodenoscopy (EGD). The current study evaluates the potential clinical utility of vital staining with methylene blue for dete...
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| Veröffentlicht in: | Gastrointestinal endoscopy 1998-07, Vol.48 (1), p.26-32 |
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| creator | Morales, Thomas G. Bhattacharyya, Achyut Camargo, Elizabeth Johnson, Cynthia Sampliner, Richard E. |
| description | Background: Previous studies by our group have identified a 23% prevalence of intestinal metaplasia involving the gastric cardia in patients undergoing elective esophagogastroduodenoscopy (EGD). The current study evaluates the potential clinical utility of vital staining with methylene blue for detecting intestinal metaplasia of the cardia. In addition, the prevalence of
Helicobacter pylori infection and incidence of dysplasia in cardia intestinal metaplasia was assessed.
Methods: Twenty-four of 104 patients undergoing elective EGD were previously identified with cardia intestinal metaplasia. Twenty-one of these 24 returned for follow-up EGD with methylene blue staining and cardia biopsies. During EGD four random biopsies were taken in the cardia. After staining with methylene blue, four targeted biopsy specimens were taken from any stained areas.
H. pylori infection was assessed by rapid urease testing and serologic evaluation.
Results: Staining with methylene blue was positive in 16, equivocal in 4, and negative in 1. Overall, cardia intestinal metaplasia was identified in 17 of 21 patients (81%) by at least one of the 8 biopsies. The sensitivity of detecting intestinal metaplasia by targeted biopsies to stained areas was 67% as opposed to 38% for random biopsies (odds ratio 3.0: 95% CI [0.88,10.24]). The prevalence of
H. pylori infection in patients with cardia intestinal metaplasia was 76%. One patient developed low-grade dysplasia, whereas the others remained negative.
Conclusions: Intestinal metaplasia of the gastric cardia is associated with a high prevalence of
H. pylori infection and is a reproducible finding in the majority of patients. Methylene blue staining and an increasing number of biopsies improve the sensitivity of detecting this potentially neoplastic lesion. (Gastrointest Endosc 1998;48:26-31.) |
| doi_str_mv | 10.1016/S0016-5107(98)70124-5 |
| format | Article |
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Helicobacter pylori infection and incidence of dysplasia in cardia intestinal metaplasia was assessed.
Methods: Twenty-four of 104 patients undergoing elective EGD were previously identified with cardia intestinal metaplasia. Twenty-one of these 24 returned for follow-up EGD with methylene blue staining and cardia biopsies. During EGD four random biopsies were taken in the cardia. After staining with methylene blue, four targeted biopsy specimens were taken from any stained areas.
H. pylori infection was assessed by rapid urease testing and serologic evaluation.
Results: Staining with methylene blue was positive in 16, equivocal in 4, and negative in 1. Overall, cardia intestinal metaplasia was identified in 17 of 21 patients (81%) by at least one of the 8 biopsies. The sensitivity of detecting intestinal metaplasia by targeted biopsies to stained areas was 67% as opposed to 38% for random biopsies (odds ratio 3.0: 95% CI [0.88,10.24]). The prevalence of
H. pylori infection in patients with cardia intestinal metaplasia was 76%. One patient developed low-grade dysplasia, whereas the others remained negative.
Conclusions: Intestinal metaplasia of the gastric cardia is associated with a high prevalence of
H. pylori infection and is a reproducible finding in the majority of patients. Methylene blue staining and an increasing number of biopsies improve the sensitivity of detecting this potentially neoplastic lesion. (Gastrointest Endosc 1998;48:26-31.)</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/S0016-5107(98)70124-5</identifier><identifier>PMID: 9684660</identifier><identifier>CODEN: GAENBQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Coloring Agents ; Digestive system ; Follow-Up Studies ; Helicobacter Infections - complications ; Helicobacter Infections - pathology ; Helicobacter pylori ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Metaplasia - diagnosis ; Metaplasia - microbiology ; Methylene Blue ; Middle Aged ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Sensitivity and Specificity ; Stomach - microbiology ; Stomach - pathology</subject><ispartof>Gastrointestinal endoscopy, 1998-07, Vol.48 (1), p.26-32</ispartof><rights>1998 American Society for Gastrointestinal Endoscopy</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-52f4714da311d4380d86a476fc990266971056d5a9dc966d6c4df5c5dca4c8fb3</citedby><cites>FETCH-LOGICAL-c389t-52f4714da311d4380d86a476fc990266971056d5a9dc966d6c4df5c5dca4c8fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0016-5107(98)70124-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2313123$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9684660$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morales, Thomas G.</creatorcontrib><creatorcontrib>Bhattacharyya, Achyut</creatorcontrib><creatorcontrib>Camargo, Elizabeth</creatorcontrib><creatorcontrib>Johnson, Cynthia</creatorcontrib><creatorcontrib>Sampliner, Richard E.</creatorcontrib><title>Methylene blue staining for intestinal metaplasia of the gastric cardia with follow-up for dysplasia</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Background: Previous studies by our group have identified a 23% prevalence of intestinal metaplasia involving the gastric cardia in patients undergoing elective esophagogastroduodenoscopy (EGD). The current study evaluates the potential clinical utility of vital staining with methylene blue for detecting intestinal metaplasia of the cardia. In addition, the prevalence of
Helicobacter pylori infection and incidence of dysplasia in cardia intestinal metaplasia was assessed.
Methods: Twenty-four of 104 patients undergoing elective EGD were previously identified with cardia intestinal metaplasia. Twenty-one of these 24 returned for follow-up EGD with methylene blue staining and cardia biopsies. During EGD four random biopsies were taken in the cardia. After staining with methylene blue, four targeted biopsy specimens were taken from any stained areas.
H. pylori infection was assessed by rapid urease testing and serologic evaluation.
Results: Staining with methylene blue was positive in 16, equivocal in 4, and negative in 1. Overall, cardia intestinal metaplasia was identified in 17 of 21 patients (81%) by at least one of the 8 biopsies. The sensitivity of detecting intestinal metaplasia by targeted biopsies to stained areas was 67% as opposed to 38% for random biopsies (odds ratio 3.0: 95% CI [0.88,10.24]). The prevalence of
H. pylori infection in patients with cardia intestinal metaplasia was 76%. One patient developed low-grade dysplasia, whereas the others remained negative.
Conclusions: Intestinal metaplasia of the gastric cardia is associated with a high prevalence of
H. pylori infection and is a reproducible finding in the majority of patients. Methylene blue staining and an increasing number of biopsies improve the sensitivity of detecting this potentially neoplastic lesion. (Gastrointest Endosc 1998;48:26-31.)</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Coloring Agents</subject><subject>Digestive system</subject><subject>Follow-Up Studies</subject><subject>Helicobacter Infections - complications</subject><subject>Helicobacter Infections - pathology</subject><subject>Helicobacter pylori</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metaplasia - diagnosis</subject><subject>Metaplasia - microbiology</subject><subject>Methylene Blue</subject><subject>Middle Aged</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Sensitivity and Specificity</subject><subject>Stomach - microbiology</subject><subject>Stomach - pathology</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtuFDEQRS1EFIaQT4jkBUKw6GB3-7lCKAISKRELyNqq8SNj5OkebDfR_D2eh2abjUtynVtVOghdUXJNCRWff5H2dpwS-VGrT5LQnnX8FVpQomUnpNSv0eKEvEFvS_lDCFH9QM_RuRaKCUEWyD34utomP3q8TLPHpUIc4_iEw5RxHKsvNY6Q8NpX2CQoEfAUcF15_ASl5mixheza73OsqxZKaXru5s0-7rblEHmHzgKk4i-P9QI9fv_2--a2u__54-7m631nB6Vrx_vAJGUOBkodGxRxSgCTIlitSS-ElpRw4ThoZ7UQTljmArfcWWBWheVwgT4c5m7y9Hdup5t1LNanBKOf5mIUIQOTfGggP4A2T6VkH8wmxzXkraHE7OyavV2zU2e0Mnu7hrfc1XHBvFx7d0oddbb--2MfioUUMow2lhPW3A-0363_csB8k_Ev-myKjX603sXsbTVuii8c8h_pVpdC</recordid><startdate>19980701</startdate><enddate>19980701</enddate><creator>Morales, Thomas G.</creator><creator>Bhattacharyya, Achyut</creator><creator>Camargo, Elizabeth</creator><creator>Johnson, Cynthia</creator><creator>Sampliner, Richard E.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980701</creationdate><title>Methylene blue staining for intestinal metaplasia of the gastric cardia with follow-up for dysplasia</title><author>Morales, Thomas G. ; Bhattacharyya, Achyut ; Camargo, Elizabeth ; Johnson, Cynthia ; Sampliner, Richard E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-52f4714da311d4380d86a476fc990266971056d5a9dc966d6c4df5c5dca4c8fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Coloring Agents</topic><topic>Digestive system</topic><topic>Follow-Up Studies</topic><topic>Helicobacter Infections - complications</topic><topic>Helicobacter Infections - pathology</topic><topic>Helicobacter pylori</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metaplasia - diagnosis</topic><topic>Metaplasia - microbiology</topic><topic>Methylene Blue</topic><topic>Middle Aged</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Sensitivity and Specificity</topic><topic>Stomach - microbiology</topic><topic>Stomach - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morales, Thomas G.</creatorcontrib><creatorcontrib>Bhattacharyya, Achyut</creatorcontrib><creatorcontrib>Camargo, Elizabeth</creatorcontrib><creatorcontrib>Johnson, Cynthia</creatorcontrib><creatorcontrib>Sampliner, Richard E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morales, Thomas G.</au><au>Bhattacharyya, Achyut</au><au>Camargo, Elizabeth</au><au>Johnson, Cynthia</au><au>Sampliner, Richard E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Methylene blue staining for intestinal metaplasia of the gastric cardia with follow-up for dysplasia</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>1998-07-01</date><risdate>1998</risdate><volume>48</volume><issue>1</issue><spage>26</spage><epage>32</epage><pages>26-32</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><coden>GAENBQ</coden><abstract>Background: Previous studies by our group have identified a 23% prevalence of intestinal metaplasia involving the gastric cardia in patients undergoing elective esophagogastroduodenoscopy (EGD). The current study evaluates the potential clinical utility of vital staining with methylene blue for detecting intestinal metaplasia of the cardia. In addition, the prevalence of
Helicobacter pylori infection and incidence of dysplasia in cardia intestinal metaplasia was assessed.
Methods: Twenty-four of 104 patients undergoing elective EGD were previously identified with cardia intestinal metaplasia. Twenty-one of these 24 returned for follow-up EGD with methylene blue staining and cardia biopsies. During EGD four random biopsies were taken in the cardia. After staining with methylene blue, four targeted biopsy specimens were taken from any stained areas.
H. pylori infection was assessed by rapid urease testing and serologic evaluation.
Results: Staining with methylene blue was positive in 16, equivocal in 4, and negative in 1. Overall, cardia intestinal metaplasia was identified in 17 of 21 patients (81%) by at least one of the 8 biopsies. The sensitivity of detecting intestinal metaplasia by targeted biopsies to stained areas was 67% as opposed to 38% for random biopsies (odds ratio 3.0: 95% CI [0.88,10.24]). The prevalence of
H. pylori infection in patients with cardia intestinal metaplasia was 76%. One patient developed low-grade dysplasia, whereas the others remained negative.
Conclusions: Intestinal metaplasia of the gastric cardia is associated with a high prevalence of
H. pylori infection and is a reproducible finding in the majority of patients. Methylene blue staining and an increasing number of biopsies improve the sensitivity of detecting this potentially neoplastic lesion. (Gastrointest Endosc 1998;48:26-31.)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>9684660</pmid><doi>10.1016/S0016-5107(98)70124-5</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Coloring Agents Digestive system Follow-Up Studies Helicobacter Infections - complications Helicobacter Infections - pathology Helicobacter pylori Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Metaplasia - diagnosis Metaplasia - microbiology Methylene Blue Middle Aged Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Sensitivity and Specificity Stomach - microbiology Stomach - pathology |
| title | Methylene blue staining for intestinal metaplasia of the gastric cardia with follow-up for dysplasia |
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