In Vivo Staining of Gastric Mucosa: Its Application to Endoscopic Diagnosis of Intestinal Metaplasia

Summary

The stain phenomenon of the gastric mucosa was examined by the indirect dye scattering method with methylene blue and the following results were obtained: 1. The stain phenomenon of the gastric mucosa with methylene blue is a certain in vivo staining based on intake of the dye to the layer of surface epithelial cells. 2. The stained region is generally located in the pyloric gland area and intestinal metaplasia is stained selectively. Therefore, it may be said that the in vivo staining method with methylene blue provides precise endoscopic diagnosis of intestinal metaplasia, which was almost impossible to be diagnosed by the usual endoscopy. 3. The staining frequency was 65.6%, showing an increase with age. The frequency was high on patients with gastric polyp, advanced gastric cancer and the scar of gastric ulcer. Ninety percent of the stained region belonged to antral type in which the antral region was mainly stained. The others belonged to intermediate type in which staining ranged to the neighbourhood of the upper boundary of the pyloric gland area. 4. The stained patterns were classified into granular and depressed type. In former type granules were stained and in latter type the small depressed regions between the granules were stained. The former type occupied 83% of the whole, and granular-antral type was considered as the most common staining patterns of the gastric mucosa.

Zusammenfassung

Bei der indirekten Anfärbung der Magenschleimhaut mit Methylenblau wurden folgende Resultate gewonnen: 1. Die in-vivo-Färbung geht auf eine Aufnahme des Farbstoffs in die Oberflächen-epithelien zurück. 2. Die angefärbte Region liegt im präpylorischen Antrum, die intestinale Metaplasie färbt sich selektiv an. 3. Bei einer Anfärbefrequenz von 65,6% war eine deutliche Altersabhängigkeit festzustellen. Sie lag besonders hoch bei Patienten mit Magenpolypen, fortgeschrittenem Magenkarzinom und in Ulkusnarben. Bei 90% färbte sich die Antrumregion, bei den restlichen auch die Intermediärzone an. 4. Es lassen sich eine granuläre Form und eine eingesenkte Form unterscheiden.

Key-Words

Intestinal metaplasia - in vivo staining - endoscopic diagnosis - staining pattern