Clinical value of acetic acid and methylene blue chromoendoscopy in the diagnosis of gastric intestinal metaplasia

doi:10.3969/j.issn.1006-7795.2013.05.009

Abstract

Abstract:

Objective To evaluate the clinical value of acetic acid and methylene blue chromoendoscopy in the diagnosis of gastric intestinal metaplasia.Methods Cases from endoscopy center of Friendship Hospital, Capital Medical University, and Beijing Xiyuan Hospital, China Academy of Traditional Chinese Medicine, suspected chronic atrophic gastritis and/or intestinal metaplasia under white light endoscopy, were randomized into acetate acid group or endoscopic and methylene blue group respectively with 0.2% methylene blue solution or 1:4 Shanghai white vinegar spraying on gastric mucosa, then the suspected area was biopsied for pathological evaluation. Results Totally 146 cases with suspected chronic atrophic gastritis and/or intestinal metaplasia under white light endoscopy, were randomized into acetate acid group (76 cases) or methylene blue group (70 cases). After 0.2% methylene blue spraying, gastric intestinal metaplasia presented with blue coloring, and clearly demarcated with surrounding mucosa, while after acetic acid spraying, gastric intestinal metaplasia presented with blue coloring became more evidently whitening, and clearly demarcated with surrounding mucosa. After staining with acetic acid, the sensitivity and specificity in the diagnosis of gastric intestinal metaplasia were 84.6% (55/65) and 90.9% (10/11) respectively, which were 82.8% (48/58) and 100% (12/12) for methylene blue, both consistent with pathological diagnosis. The diagnosing rate of gastric intestinal metaplasia with acetate acid and methylene blue staining were 73.7% (56/76) and 68.6% (48/70), the difference was not statistically significant (P>0.05). The diagnostic sensitivity of gastric intestinal metaplasia with acetate acid and methylene blue staining were 84.6% and 82.8% (P=0.769). The diagnostic specificity of gastric intestinal metaplasia with acetate acid and methylene blue staining were 90.9% and 100% (P=0.009). Conclusion Acetic acid and methylene blue staining both contribute to the diagnosis of gastric intestinal metaplasia. Acetic acid had higher specificity than methylene blue staining for the diagnosis of gastric intestinal metaplasia.

Key words: acetic acid, methylene blue, intestinal metaplasia, endoscopy

CLC Number:

R768.3

LI Peng, WANG Yongjun, SUN Mingjiong, ZHANG Nana, ZHANG Shutian, WANG Fengyun, TANG Xudong. Clinical value of acetic acid and methylene blue chromoendoscopy in the diagnosis of gastric intestinal metaplasia[J]. Journal of Capital Medical University, 2013, 34(5): 679-683.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.05.009

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I5/679

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