Because of a rapid increase in the incidence of Barrett's cancer, the appropriate surveillance method for Barrett's esophagus is of interest.
Methylene blue chromoendoscopy has been reported to be an effective and inexpensive method to improve biopsy surveillance of Barrett's epithelium.
However, the usefulness of this method in short-segment Barrett's esophagus cases is still controversial.
Dr Amano and colleagues from Izumo, Japan undertook a study in order to evaluate the abilities of crystal violet and methylene blue chromoendoscopy to detect potentially dysplastic Barrett's epithelium in cases with short-segment columnar-appearing epithelium of the esophago-gastric junction.
The researchers enrolled a total of 400 patients with endoscopically suspected short-segment Barrett's esophagus.
The research team randomly assigned the participants to receive chromoendoscopy with 0.05% crystal violet, 0.1% crystal violet, 0.5% methylene blue, or 1.0% methylene blue.
| Chromoendoscopy with 0.05% crystal violet detected histologically confirmed Barrett's epithelium with the highest sensitivity|
|American Journal of Gastroenterology|
During crystal violet and methylene blue chromoendoscopy, the investigators obtained biopsy specimens from stained and unstained columnar-appearing epithelium of the esophago-gastric junction.
The researchers evaluated the detection rates of Barrett's epithelium.
The value of pit pattern diagnosis was also evaluated as a possible way to detect dysplastic Barrett's epithelium.
The researchers found that chromoendoscopy with 0.05% crystal violet detected histologically confirmed Barrett's epithelium with the highest sensitivity (89.2%) and specificity (85.7%).
The research team found that crystal violet clearly stained both dysplastic and nondysplastic Barrett's epithelia and made the surface pit pattern easy to observe without using magnifying endoscopy.
Dr Amano concluded, "The combination of crystal violet chromoendoscopy and pit pattern diagnosis is considered to be useful for the surveillance of short-segment Barrett's esophagus."