Abstract:
BACKGROUND:Previous studies by our group have identified a 23% prevalence of intestinal metaplasia involving the gastric cardia in patients undergoing elective esophagogastroduodenoscopy (EGD). The current study evaluates the potential clinical utility of vital staining with methylene blue for detecting intestinal metaplasia of the cardia. In addition, the prevalence of Helicobacter pylori infection and incidence of dysplasia in cardia intestinal metaplasia was assessed. METHODS:Twenty-four of 104 patients undergoing elective EGD were previously identified with cardia intestinal metaplasia. Twenty-one of these 24 returned for follow-up EGD with methylene blue staining and cardia biopsies. During EGD four random biopsies were taken in the cardia. After staining with methylene blue, four targeted biopsy specimens were taken from any stained areas. H. pylori infection was assessed by rapid urease testing and serologic evaluation. RESULTS:Staining with methylene blue was positive in 16, equivocal in 4, and negative in 1. Overall, cardia intestinal metaplasia was identified in 17 of 21 patients (81%) by at least one of the 8 biopsies. The sensitivity of detecting intestinal metaplasia by targeted biopsies to stained areas was 67% as opposed to 38% for random biopsies (odds ratio 3.0: 95% CI [0.88,10.24]). The prevalence of H. pylori infection in patients with cardia intestinal metaplasia was 76%. One patient developed low-grade dysplasia, whereas the others remained negative. CONCLUSIONS:Intestinal metaplasia of the gastric cardia is associated with a high prevalence of H. pylori infection and is a reproducible finding in the majority of patients. Methylene blue staining and an increasing number of biopsies improve the sensitivity of detecting this potentially neoplastic lesion.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Morales TG,Bhattacharyya A,Camargo E,Johnson C,Sampliner REdoi
10.1016/s0016-5107(98)70124-5subject
Has Abstractpub_date
1998-07-01 00:00:00pages
26-31issue
1eissn
0016-5107issn
1097-6779pii
S0016-5107(98)70124-5journal_volume
48pub_type
杂志文章abstract:BACKGROUND:Enteral feeding by percutaneous endoscopic gastrostomy is indicated as long-term nutritional support for children with neurologic impairment and dysphagia. We report our experience with percutaneous endoscopic gastrostomy and evaluate the age range of children with cerebral palsy who benefit most with weight...
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pub_type: 临床试验,杂志文章
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journal_title:Gastrointestinal endoscopy
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-03-01 00:00:00
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更新日期:1990-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1067/mge.2000.108408
更新日期:2000-09-01 00:00:00
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更新日期:2009-03-01 00:00:00
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更新日期:2010-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2006-08-01 00:00:00
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更新日期:2007-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:1996-07-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章,实务指引
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