Comparison of chromoendoscopy and conventional endoscopy in the detection of premalignant gastric lesions
SA Taghavi | M Membari | A Eshraghian | SM Dehghani | L Hamidpour | F Khademalhoseini
BACKGROUND: Diagnosis and localization of intestinal metaplasia
and early gastric cancer is problematic because of the lack of any telltale
gross endoscopic signs.
OBJECTIVE: To compare the efficacy of chromoendoscopy with conventional
endoscopy for the detection of gastric premalignant lesions
METHOD: Thirty-three patients in whom previous routine endoscopic
biopsies showed intestinal metaplasia were enrolled in a prospective
study. Each patient underwent a two-step endoscopy
procedure: conventional endoscopy and chromoendoscopy using
methylene blue. Biopsies were taken during each step and were studied
by an expert pathologist. Presence of intestinal metaplasia was considered
a positive result.
RESULTS: Considering the presence of intestinal metaplasia anywhere
in the stomach as a positive result, 13 patients were diagnosed
with intestinal metaplasia using both endoscopic methods, while eight
patients had positive results using chromoendoscopy without any
metaplastic changes detected with the conventional method
(P=0.003). One patient showed positive biopsies with the conventional
method while the pathology report showed no positive biopsies
using the chromoendoscopy method. The number of positive biopsies
from the antrum, body and fundus were 18, 15 and seven, respectively,
using chromoendoscopy, and 10, four and two, respectively, from the
same sites using conventional endoscopy.
CONCLUSION: The present study demonstrated that chromoendoscopy
is superior to conventional endoscopy for the detection of metaplastic
changes and its use can be suggested for the screening of early
malignancies of the stomach.