Comparison of methylene blue-directed biopsies and conventional biopsies in the detection of intestinal metaplasia and dysplasia in Barrett's esophagus: a preliminary study
Comparison of methylene blue-directed biopsies and conventional biopsies in the detection of intestinal metaplasia and dysplasia in Barrett's esophagus: a preliminary study
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DOI：
10.1067/mge.2001.115732
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发表时间：
2001-09-01
影响因子：
7.7
通讯作者：
Wilson, MA
中科院分区：
文献类型：
--
作者：
Wo, JM;Ray, MB;Wilson, MA
背景亚甲蓝（MB）染色内镜在Barrett食管的诊断优势尚不清楚。方法：柱状内衬食管（CLE）患者参加了一项前瞻性，随机交叉试验MB定向活检与常规活检。结果：47例患者（19例长段CLE; 28例短段CLE）参加并接受MB定向活检。MB对特化肠上皮化生的敏感性和特异性分别为53%和51%。MB对异型增生的敏感性和特异性分别为51%和48%。35例患者（15例长节段CLE; 20例短节段CLE）完成了交叉试验。MB导向和常规活检标本中特化肠上皮化生的相对频率分别为73%和71%（p = 0.73）。MB导向和常规活检标本中异型增生的相对频率分别为20%和18%（p = 0.65）。在长节段CLE患者中，10例MB患者和7例常规活检方法患者诊断为异型增生（p = 0.25）。MB组每个EGD的活检标本数量更多，这可能影响了诊断。组织学上，不典型增生的等级是不确定的/低，几乎所有的不典型增生samples.Conclusions：结果MB定向活检检测专门的肠上皮化生和不确定/低度异型增生的常规活检是相似的。MB在短节段Barrett食管中无效。
Background. The diagnostic advantage of methylene blue (MB) chromoendoscopy in Barrett's esophagus is unclear.Methods: Patients with columnar-lined esophagus (CLE) were enrolled into a prospective, randomized crossover trial of MB-directed biopsy versus conventional biopsy.Results: Forty-seven patients (19 long-segment CLE; 28 short-segment CLE) were enrolled and underwent MB-directed biopsy. Sensitivity and specificity of MB for specialized intestinal metaplasia were 53% and 51%, respectively. Sensitivity and specificity of MB for dysplasia were 51% and 48%, respectively. Thirty-five patients (15 long-segment CLE; 20 short-segment CLE) completed the crossover trial. Relative frequencies for specialized intestinal metaplasia were 73% and 71% from MB-directed and conventional biopsy specimens, respectively (p = 0.73). Relative frequencies for dysplasia were 20% and 18% from MB-directed and conventional biopsy specimens, respectively (p = 0.65). In patients with long-segment CLE, dysplasia was diagnosed in 10 patients with MB and 7 patients with conventional biopsy methods (p = 0.25). The number of biopsy specimens per EGD was greater with MB, which may have influenced the diagnosis. Histologically, the grade of dysplasia was indefinite/low in nearly all of the dysplastic specimens.Conclusions: Results of MB-directed biopsy were similar to conventional biopsy in detecting specialized intestinal metaplasia and indefinite/low-grade dysplasia. MB was not useful in short-segment Barrett's esophagus.