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ISSN 0185-6014 (Print)
Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2009, Number 1

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Rev Mex Patol Clin Med Lab 2009; 56 (1)

Validation of the tinction with methylene blue to 0.5% in diagnosis of Barrett´s esophagus at the Instituto de Gastroenterología. La Habana, Cuba

Hernández GHR, Galbán GE, Gonzáles EE, Silva SAP, Castellanos GV, Rondon F, Andrain SY

Language: Spanish
References: 28
Page: 10-17
PDF size: 82.21 Kb.


ABSTRACT

Barrett’s esophagus is one of the most complex and less conversant consequences of GERD. In intestinal metaplasia, characterized by histological approaches the potentiality of wicked transformation exists, through very well-known stages (dysplasia of low or high grade and finally the adenocarcinoma development). We proceeded to chromoendoscopy evaluation, of the mucous esophagi using Methylene blue to 0.5%, to determine the agreement or reproducibly among the taking of biopsies managed previous tint and the histological study. By means of study they were included, 21 patients with esophagus of Barrett and 39 without esophagus of Barrett. The mean prevalence of esophagus of Barrett in our cases was 0.5%. The sensibility of the chromoendoscopy with methylene blue to 0.5% in the studied patients was 100% IC95% (84.5-100%) and the specificity 76.9%. IC95% (61.7-87.4%). The predictive positive value of the tint was 70.0% IC95% (52.1-83.3%) and the predictive negative value was 100% IC95% (88.6-100%). The diagnostic accuracy of the tint chromo endoscopic evaluation in the studied patients was 85.0% IC95% (73.9-91.9%). The chromoendoscopy with methylene blue instillation to 0.5%, favors the managed taking of biopsies and it increases the sensibility of the diagnosis of intestinal metaplasia: intestinal metaplasia characteristics of Barrett’s esophagus.


REFERENCES

  1. Sampliner RE. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1998; 93: 1028-1032.

  2. Bell NVJ, Hunt RH. Role of gastric acid suppression in the treatment of gastroesophageal reflux disease. Gut 1992; 33: 118-124.

  3. Csendes A, Braghetto I, Burdiles P, Puente G, Korn O, Diaz JC et al. Long-term results of classic antireflux surgery in 152 patients with Barrett’s esophagus: Clinical, radiologic, endoscopic, manometric and acid reflux test analysis before and late after operation. Surgery 1998; 123: 645-657.

  4. Csendes A, Braghetto I, Burdiles P, Diaz JC, Maluenda F, Korn O. A new physiologic approach for the surgical treatment of patients with Barrett’s esophagus. Technical considerations and results in 65 patients. Ann Surg 1997; 226: 123-133.

  5. Sampliner RE, Garewal HS, Fenerty MB, Aickin M. Lack of impact of therapy on extent of Barrett’s esophagus in 67 patients. Dig Dis Sci 1990; 35: 93-96.

  6. Berenson MM, Johnson TD, Markowitz NR, Buchi KN, Samowitz WS. Restoration of squamous mucosa after ablation of Barrett’s esophageal epithelium. Gastroenterology 1993; 104: 1686-1691.

  7. Mathew G, Watson DI, Myers JC, Holloway RH, Jamieson GG. Oesophageal motility before and after laparoscopic Nissen fundoplication. Br J Surg 1997; 84: 1465-1469.

  8. Spechler SJ, Goyal RK. The columnar-lined esophagus, intestinal metaplasia, and Norman Barrett. Gastroenterology 1996; 110: 614-621.

  9. Bremner CG, Lynch VP, Ellis FH. Barrett’s esophagus: Congenital or acquired? An experimental study of esophageal mucosal regeneration in the dog. Surgery 1970; 68: 209-216.

  10. Paull A, Trier JS, Dalton MD, Camp RC, Loeb P, Goyal RK. The histologic spectrum of Barrett’s esophagus. N Engl J Med 1976; 295: 476-480.

  11. Devesa SS, Blot WJ, Fraumeni JF. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998; 83: 2049-2053.

  12. Canto MI, Setrakian S, Willis JE, Chak A, Petras RE, Sivak MV. Methilene blue staining of dysplastic and nondysplastic Barrett’s esophagus: An in vivo and ex vivo study. Endoscopy 2001; 33: 391-400.

  13. Canto MI, Yoshida T, Gossner L. Chromoscopy of intestinal metaplasia in Barrett’s esophagus. Endoscopy 2002; 34: 330-6.

  14. Sharma P, Topalovski M, Mayo MS, Weston AP. Methylene blue chromoendoscopy for detection of short-segment Barrett’s esophagus. Gastrointest Endosc 2001; 54: 289-293.

  15. Wo JM, Ray MB, Mayfield-Stokes S, Al-Sabbagh G, Gebrail F, Sloane SP et al. Comparison of methilene blue-directed biopsies and conventional biopsies in the detection of intestinal metaplasia and dysplasia in Barrett’s esophagus: A preliminary study. Gastrointest Endosc 2001; 54: 294-301.

  16. Dave U, Shouisa S, Westay D. Methilene blue staining: Is it really useful in Barrett’s esophagus? Gastrointest Endosc 2001; 53: 333-335.

  17. Kiesslich R, Hahn M, Herrmann G, Jung M. Screening for specialized columnar epithelium with methylene blue: Chromoendoscopy in patients with Barrett’s esophagus and a normal control group. Gastrointest Endosc 2001; 53: 47-52.

  18. Tytgat GNT, Hameeteman W, Onstenk R, Schorborg R. The spectrum of columnar-lined esophagus: Barrett´s esophagus. Endoscopy 1989; 21: 177-185.

  19. Vakil N, VanZanten S , Dent J , Kahrilas P, Jones R. The definition of GERD a global evidence-based consensus. Gastroenterology 2006; 130: A-394 [#M2010].

  20. Sharma P, Armstrong D, Berman J. The development and validation of an endoscopic grading system for Barrett’s esophagus. The Prague C and M criteria. Gastroenterology 2006; 130: A 121 [#820].

  21. Leodolter A, Oberueber P, Zielinski D, Vieth M, Stolte M, Labenz J. Prospective evaluation of the new Prague classification for Barrett’s esophagus. Gastroenterology 2006; 130: A-265 (#S1828).

  22. Sampliner RE. Adenocarcinoma of the esophagus and gastric cardia: Is there progress in the face of increasing cancer incidence? Ann Intern Med 1999; 130: 67-69.

  23. Sampliner RE, Steinbronn K, Garewal HS. Squamous mucosa overlying columnar epithelium in Barrett´s esophagus in the absence of anti-reflux surgery. Am J Gastroenterol 1988; 83: 510-512.

  24. Sjogren RW, Johnson LF. Barrett´s esophagus: A review. Am J Med 1983; 74: 313-321.

  25. Canto MI, Setrakian S, Willis J, Chak A, Petras R, Powe NR et al. Methylene blue-directed biopsies improve detection of intestinal metaplasia and dysplasia in Barrett’s esophagus. Gastrointest Endosc 2000; 51: 560-568.

  26. Kouklakis GS, Kountouras J, Dokas SM. Methylene blue chromoendoscopy for the detection of Barrett’s esophagus in a Greek cohort. Endoscopy 2003; 35: 383-387.

  27. Endo T, Awakawa T, Takahashi H. Classification of Barrett’s epithelium by magnifying endoscopy. Gastrointest Endosc 2002; 55: 641-647.

  28. Yagi K, Nakamura A, Sekine A. Accuracy of magnifying endoscopy with methylene blue in the diagnosis of specialized intestinal metaplasia and short-segment Barrett’s esophagus in Japanese patients without Helicobacter pylori infection. Gastrointest Endosc 2003; 58: 189-195.




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