Diagnostic efficacy of methylene blue staining combined with light transmission method in endoscopic submucosal dissection samples of early gastric cancer
10.3760/cma.j.cn321463-20250211-00053
- VernacularTitle:亚甲蓝染色透光法在早期胃癌内镜黏膜下剥离术标本诊断中的价值
- Author:
Mei JIA
1
;
Kuiliang LIU
;
Rui XU
;
Bing YUE
;
Yang GAO
;
Xue MEI
;
Guangyong CHEN
Author Information
1. 首都医科大学附属北京友谊医院病理科，北京 100050
- Publication Type:Journal Article
- Keywords:
Methylene blue;
Light transmission;
Early gastric cancer;
Endoscopic submucosal dissection;
Endoscopy-pathological comparison
- From:
Chinese Journal of Digestive Endoscopy
2025;42(8):602-607
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic efficacy of methylene blue staining combined with light transmission method (termed as light transmission and staining) in endoscopic submucosal dissection (ESD) specimens of early gastric cancer.Methods:A retrospective study was conducted on 75 specimens of early gastric cancer treated with ESD at Beijing Friendship Hospital, Capital Medical University from October 2021 to August 2023. Under a stereomicroscope, magnified observation and transmitted light transmission and staining observation were performed to compare the demarcation line (DL), irregular microvascular pattern (IMVP) and irregular microsurface pattern (IMSP) of the lesion, and the differences among histological types were compared. Furthermore, the false positive rate of surgical margin, the detection rate of undifferentiated cancer and multifocal lesions were compared against the 88 controls processed by traditional method.Results:Using the light transmission and staining method, DL, IMVP and IMSP were detected in 96.0% (72/75), 89.3% (67/75), and 98.7% (74/75), which was higher than 72.0% (54/75), 6.7% (5/75), and 26.7% (20/75) by using the magnified observation ( χ 2=8.036, P<0.001; χ 2=0.640, P<0.001; χ 2=0.369, P<0.001). There was no statistical difference in the coincidence rate of endoscopy and pathology between differentiated type, undifferentiated type and mixed type [92.2% (59/64), 50.0% (1/2), 77.8% (7/9), χ 2=5.145, P=0.055]. Compared to traditional methods, light transmission and staining could increase the detection rate of undifferentiated cancer [14.7% (11/75) VS 4.5% (4/88), χ 2=4.964, P=0.026] and reduce the false positive rate of surgical margins [1.3% (1/75) VS 11.4% (10/88), χ 2=4.585, P=0.032], but showed no statistical difference in the detection rate of multifocal lesions [5.3% (4/75) VS 0.0% (0/88), χ 2=2.841, P=0.094]. Conclusion:Light transmission and staining enhances pathological recognition of DL, IMVP and IMSP during specimen processing, improving detection of undifferentiated cancer and reducing false positive of margin.
