Clinical Endoscopy

  • 제56권2호
  • /
  • Pages.203-213
  • /
  • 2023
  • /
  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Methylene blue chromoendoscopy is more useful in detection of intestinal metaplasia in the stomach than mucosal pit pattern or vessel evaluation and predicts advanced Operative Link on Gastric Intestinal Metaplasia stages

  • Justyna Wasielica-Berger (Department of General Pathomorphology, Medical University of Bialystok) ;
  • Pawel Rogalski (Department of Gastroenterology and Internal Medicine, Medical University of Bialystok) ;
  • Anna Pryczynicz (Department of General Pathomorphology, Medical University of Bialystok) ;
  • Agnieszka Swidnicka-Siergiejko (Department of Gastroenterology and Internal Medicine, Medical University of Bialystok) ;
  • Andrzej Dabrowski (Department of Gastroenterology and Internal Medicine, Medical University of Bialystok)
  • 투고 : 2022.02.26
  • 심사 : 2022.05.30
  • 발행 : 2023.03.30
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초록

Background/Aims: Intestinal metaplasia (IM) of the stomach is a precancerous condition that is often not visible during conventional endoscopy. Hence, we evaluated the utility of magnification endoscopy and methylene blue (MB) chromoendoscopy to detect IM. Methods: We estimated the percentage of gastric mucosa surface staining with MB, mucosal pit pattern, and vessel visibility and correlated it with the presence of IM and the percentage of metaplastic cells in histology, similar to the Operative Link on Gastric Intestinal Metaplasia (OLGIM) stage. Results: IM was found in 25 of 33 (75.8%) patients and in 61 of 135 biopsies (45.2%). IM correlated with positive MB staining (p<0.001) and other than dot pit patterns (p=0.015). MB staining indicated IM with better accuracy than the pit pattern or vessel evaluation (71.7% vs. 60.5% and 49.6%, respectively). At a cut-off point of 16.5% for the MB-stained gastric surface, the sensitivity, specificity, and accuracy of chromoendoscopy in the detection of advanced OLGIM stages were 88.9%, 91.7%, and 90.9%, respectively. The percentage of metaplastic cells detected on histology was the strongest predictor of positive MB staining. Conclusions: MB chromoendoscopy can serve as a screening method for detecting advanced OLGIM stages. MB mainly stains IM areas with a high concentration of metaplastic cells.

키워드

과제정보

The study was carried out using funds from the Medical University of Bialystok, grants number 133- 51826 L and 133-14657 P.

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