Methylene blue staining: Is it really useful in Barrett's esophagus?

The usefulness of chromoendoscopy with methylene blue in Barrett’s metaplasia and early esophageal carcinoma

“…The specificities were 0.99 and 1.00 for conventional endoscopic and chromoendoscopic examinations, respectively. The sensitivity for detecting intestinal metaplasia via four biopsies targeted to stained areas and via four random conventional biopsies was found, respectively, to be 53% to 51%, 57% to 32%, 67% to 38%, and 63% to 51% [16,[30][31][32]. We found the sensitivity and specificity rates of methylene blue staining for detecting specialized columnar epithelium to be 87% and 71%, respectively.…”

“…Kiesslich et al [28] found the sensitivity and specificity of methylene blue staining for the diagnosis of Barrett's epithelium to be 98% and 61%, respectively. However, Wo et al [16], Dave et al [30], Morales et al [31], and Duncan et al [32] found no statistical difference in sensitivity and specificity between conventional endoscopic and chromoendoscopic examinations for the diagnosis of esophageal carcinoma. The sensitivity was 0.95 with both techniques.…”

“…The mean cost of methylene blue staining is less than US$9, and the procedure requires approximately 8 min more time than conventional endoscopy. Thus the time required for methylene blue staining equals that for random biopsies used to diagnose Barrett's epithelium [30,34].…”

Chromoendoscopy: From a Research Tool to Clinical Progress

“…Only intestinal metaplasia absorbs this stain, showing the persistence of blue color after washing (fig 2). The results and conclusions of the study performed by Canto et al [37] were confirmed by some authors [38,39], but contradicted by others [40][41][42]. Methodological differences contribute to the diverging results, and certainly there is a learning curve to run through when someone starts to apply this technique.…”

Esôfago de Barrett: novos métodos diagnósticos

“…Comparando áreas coradas e não-coradas em apenas nove pacientes com EB, DAVE et al (6) mostraram correlação muito menor entre áreas coradas e a presença de epitélio com MI (sensibilidade de 57% e especificidade de 32%), e WO et al (13) observaram sensibilidade de 53% e especificidade de 51%. Nesses estudos também não foi comprovado o papel da coloração com azul de metileno para melhor avaliar as áreas de displasia de alto grau ou adenocarcinoma.…”