A Self-control Study of Acetic Acid Stain-guided Biopsies in Detection of Intestinal Metaplasia and Dysplasia in Barrett’s Esophagus
10.3969/j.issn.1008-7125.2015.03.005
- VernacularTitle:乙酸染色靶向活检诊断Barrett食管肠上皮化生和异型增生的自身对照研究
- Author:
Jia DING
;
Lei ZHOU
;
Yijun SUN
;
Jianping GAO
;
Hong WANG
- Publication Type:Journal Article
- Keywords:
Barrett’s Esophagus;
Acetic Acid Stain-Guided Biopsy;
Four-Quadrant Biopsy;
Intestinal Metaplasia;
Dysplasia;
Diagnosis
- From:
Chinese Journal of Gastroenterology
2015;(3):147-150
- CountryChina
- Language:Chinese
-
Abstract:
Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.
