Polish journal of pathology : official journal of the Polish Society of Pathologists · 2011
Endoscopic versus histological diagnosis of Barrett's esophagus: a cross-sectional survey.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Irvanloo Giti, Fallahi Behnaz, Ensani Fereshte, Azmi Mehrdad, Morteza Afsaneh
Аннотация
CONTEXT: Barrett's esophagus is a common pathological condition in patients with gastro-esophageal reflux disease.
OBJECTIVE: The aim of this study was to compare endoscopic diagnosis versus histological confirmation.
DESIGN: Cross-sectional.
SETTING: Cancer Institute of the Imam Khomeini Hospital.
MATERIAL AND METHODS: A total of 50 patients with a history of gastro-esophageal reflux were recruited and underwent upper endoscopy at this cross-sectional survey. Four-quadrant biopsy was taken from all suspected areas of intestinal metaplasia. Sections of blocks were stained with Mixed Alcian Blue (PH 2.5)/PAS and haematoxylin-eosin stainings for the diagnosis of intestinal metaplasia (complete vs. incomplete types) and goblet cell / columnar cell / dysplasia, respectively.
MAIN OUTCOME MEASURE: The presence of Helicobacter pylori was assessed by Giemsa staining.
RESULTS: There were 44 cases of short-segment Barrett's esophagus and 6 of long-segment Barretts esophagus by endoscopy. When examined by histologic examination, 12 patients with short-segment Barrett's esophagus and 4 with long-segment Barrett's esophagus had intestinal metaplasia. Haematoxylin-eosin staining diagnosed 12 cases of intestinal metaplasia, whereas mixed alcian blue/PAS was used to diagnose 16 cases (κ = 80%, p < 0.001). The positive predictive value in the diagnosis of goblet cell metaplasia and columnar cell metaplasia was 32% and 66%, respectively. Helicobacter pylori infection was observed in 10 cases of those with columnar cell metaplasia without goblet cells, while none of the patients with intestinal metaplasia were infected.
CONCLUSION: Our findings suggest that biopsy taking is necessary in all patients with gastro-esophageal reflux disease, whose results suggest columnar cell lining in distal esophagus in endoscopy.
OBJECTIVE: The aim of this study was to compare endoscopic diagnosis versus histological confirmation.
DESIGN: Cross-sectional.
SETTING: Cancer Institute of the Imam Khomeini Hospital.
MATERIAL AND METHODS: A total of 50 patients with a history of gastro-esophageal reflux were recruited and underwent upper endoscopy at this cross-sectional survey. Four-quadrant biopsy was taken from all suspected areas of intestinal metaplasia. Sections of blocks were stained with Mixed Alcian Blue (PH 2.5)/PAS and haematoxylin-eosin stainings for the diagnosis of intestinal metaplasia (complete vs. incomplete types) and goblet cell / columnar cell / dysplasia, respectively.
MAIN OUTCOME MEASURE: The presence of Helicobacter pylori was assessed by Giemsa staining.
RESULTS: There were 44 cases of short-segment Barrett's esophagus and 6 of long-segment Barretts esophagus by endoscopy. When examined by histologic examination, 12 patients with short-segment Barrett's esophagus and 4 with long-segment Barrett's esophagus had intestinal metaplasia. Haematoxylin-eosin staining diagnosed 12 cases of intestinal metaplasia, whereas mixed alcian blue/PAS was used to diagnose 16 cases (κ = 80%, p < 0.001). The positive predictive value in the diagnosis of goblet cell metaplasia and columnar cell metaplasia was 32% and 66%, respectively. Helicobacter pylori infection was observed in 10 cases of those with columnar cell metaplasia without goblet cells, while none of the patients with intestinal metaplasia were infected.
CONCLUSION: Our findings suggest that biopsy taking is necessary in all patients with gastro-esophageal reflux disease, whose results suggest columnar cell lining in distal esophagus in endoscopy.