indigo-carmine and Gastritis

Because endoscopic submucosal dissection (ESD) of gastric cancer can only be curative if the cancer is detected at an early stage and a precise preoperative diagnosis is made, we reviewed the detection and characterization of early gastric cancer (EGC) using both conventional endoscopy with white-light imaging (C-WLI) and image-enhanced endoscopy (chromoendoscopy [CE] and magnifying narrow-band imaging [M-NBI]). Systematic screening of the stomach by C-WLI after ideal preparation of the patient is important for detecting a mucosal lesion, which can then be characterized using CE. However, a limitation of C-WLI with CE is the diagnosis of flat or small gastric cancers. To overcome this, M-NBI together with a comprehensive diagnostic system, termed the 'vessel plus surface classification' system, was developed and has proven very useful. Preoperative assessment for ESD involves determining: (i) histological type; (ii) size; (iii) depth of invasion; (iv) presence or absence of associated ulceration; and (v) horizontal extent of the cancer. A limitation of endoscopic diagnosis using M-NBI is the histologically undifferentiated type of carcinoma, in which case the biopsy specimen is used to make a histopathological diagnosis.

Topics: Biopsy; Coloring Agents; Diagnosis, Differential; Dissection; Early Diagnosis; Gastric Mucosa; Gastritis; Gastroscopy; Image Enhancement; Indigo Carmine; Mass Screening; Microvessels; Narrow Band Imaging; Neoplasm Invasiveness; Neoplasm Staging; Precancerous Conditions; Prognosis; Stomach Neoplasms; Stomach Ulcer

Endoscopic features corresponding to pathological findings in the Sydney System have not been identified, and endoscopic diagnosis of chronic gastritis has not yet been established. To establish the diagnosis of Helicobacter pylori (H. pylori) infection in gastric mucosa by endoscopic features, a prospective multicenter study was carried out.. Two hundred and ninety-seven registered patients from 24 facilities between March 2008 and February 2009 were enrolled. Association between endoscopic findings (conventional findings and indigocarmine contrast (IC) method findings) and diagnosis of H. pylori infection made by microscopic observation of biopsy specimens was investigated in the corpus and antrum and their diagnostic accuracies were investigated.. Two hundred and seventy-five patients were analyzed. The area under the receiver operating characteristic (ROC) curve for H. pylori infection of conventional endoscopy was 0.811 in thecorpus and 0.707 in the antrum (P = 0.006). Evaluation of diffuse redness, spotty redness and mucosal swelling by conventional endoscopy and swelling of areae gastricae by the indigocarmine contrast (IC) method were useful for diagnosing H. pylori infection. Regular arrangement of collecting venules (RAC) in the angle, fundic gland polyposis, hemorrhagic erosion and bleeding spot in the corpus and red streaks, and erosions (flat, raised, hemorrhagic and bleeding spot) in the antrum may be used as diagnostic features suggesting negative H. pylori infection.. It is suggested that endoscopic diagnosis of H. pylori infection in gastric mucosa by conventional endoscopy and the IC method is mostly possible.

Topics: Adult; Aged; Area Under Curve; Biopsy, Needle; Chronic Disease; Contrast Media; Female; Gastric Mucosa; Gastritis; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Immunohistochemistry; Indigo Carmine; Male; Middle Aged; Prospective Studies; ROC Curve; Sensitivity and Specificity

Topics: Adult; Aged; Female; Gastric Juice; Gastritis; Gastrointestinal Motility; Hormones; Humans; Indigo Carmine; Male; Middle Aged; Salivary Proteins and Peptides; Stimulation, Chemical; Stomach