alcian-blue and Gastroesophageal-Reflux

Barrett's esophagus is a common pathological condition in patients with gastro-esophageal reflux disease.. The aim of this study was to compare endoscopic diagnosis versus histological confirmation.. Cross-sectional.. Cancer Institute of the Imam Khomeini Hospital.. 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.. The presence of Helicobacter pylori was assessed by Giemsa staining.. 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.. 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.

Topics: Alcian Blue; Barrett Esophagus; Biopsy; Cross-Sectional Studies; Esophagoscopy; Esophagus; Female; Gastritis; Gastroesophageal Reflux; Helicobacter Infections; Humans; Male; Metaplasia; Middle Aged; Periodic Acid-Schiff Reaction; Predictive Value of Tests

Topics: Alcian Blue; Barrett Esophagus; Coloring Agents; Gastroesophageal Reflux; Humans; Observer Variation; Prevalence

Prevalence of short segment Barrett's (SSB) oesophagus, defined as the absence of macroscopic Barrett's but histologically identifiable intestinal metaplasia, has been reported to be 18% based on haematoxylin and eosin (H&E) staining.. To define the prevalence of SSB oesophagus using H&E and alcian blue staining and to determine whether SSB oesophagus is associated with inflammation at the gastro-oesophageal junction (GOJ).. Consecutive patients (n = 158) presenting for endoscopy completed a structured interview.. Two biopsy specimens taken from the GOJ were stained with H&E, alcian blue and Giemsa. A third specimen was obtained from the distal oesophagus. Intestinal metaplasia was diagnosed if goblet cells were definitely identified by two independent observers.. SSB oesophagus was present in 46 (prevalence 36%, 95% confidence interval (CI) 28.5-43.5) using alcian blue staining. If H&E had been the sole staining method used, 50% cases of intestinal metaplasia would have been overlooked. There were no cases of intestinal metaplasia identified by H&E but missed by alcian blue staining. Logistic regression analysis identified age (odds ratio (OR) per decade 1.03, 95% CI 1.01-1.06), histological oesophagitis (OR 3.2, 95% CI 1.4-7.2) and inflammation at the gastrooesophageal junction (OR 5.9, 95% CI 2.2-15.6) as independent risk factors for SSB oesophagus.. Unrecognised SSB oesophagus is highly prevalent in patients presenting for diagnostic upper endoscopy if alcian blue staining is applied.

Topics: Adult; Alcian Blue; Barrett Esophagus; Esophagitis; Esophagogastric Junction; Female; Gastroesophageal Reflux; Gastroscopy; Humans; Male; Metaplasia; Middle Aged; Prevalence; Risk Factors; Staining and Labeling