ENDOSCOPIC VERSUS HISTOLOGICAL DIAGNOSIS OF BARRETT 'S ESOPHAGUS : A CROSS -SECTIONAL SURVEY

Context:Barrett’sesophagusisa commonpathologicalconditioninpatientswith gastro-esophagealrefluxdisease. Objective:Theaimofthisstudywastocompareendoscopicdiagnosisversushis tologicalconfirmation. Design: Cross-sectional.Setting :CancerInstituteoftheImamKhomeiniHospital. Materialandmethods: Atotalof50patientswitha historyofgastro-esophageal refluxwererecruitedandunderwentupperendoscopyatthiscross-sectionalsurvey. Four-quadrantbiopsywastakenfromallsuspectedareasofintestinalmetaplasia. SectionsofblockswerestainedwithMixedAlcianBlue(PH2.5)/PASandhaema toxylin-eosinstainingsforthediagnosisofintestinalmetaplasia(completevs.incomplete types)andgobletcell/columnarcell/dysplasia,respectively. Mainoutcomemeasure: Thepresenceof Helicobacter pyloriwasassessedbyGiem sastaining. Results: Therewere44casesofshort-segmentBarrett’sesophagusand6oflongsegmentBarrettsesophagusbyendoscopy.Whenexaminedbyhistologicexamination, 12patientswithshort-segmentBarrett’sesophagusand4withlong-segmentBar rett’sesophagushadintestinalmetaplasia.Haematoxylin-eosinstainingdiagnosed 12casesofintestinalmetaplasia,whereasmixedalcianblue/PASwasusedtodiag nose16cases( κ=80%,p<0.001).Thepositivepredictivevalueinthediagno sisofgobletcellmetaplasiaandcolumnarcellmetaplasiawas32%and66%,re spectively. Helicobacter pyloriinfectionwasobservedin10casesofthosewithcolum narcellmetaplasiawithoutgobletcells,whilenoneofthepatientswithintestinal metaplasiawereinfected. Conclusion: Ourfindingssuggestthatbiopsytakingisnecessaryinallpatientswith gastro-esophagealrefluxdisease,whoseresultssuggestcolumnarcellliningindis talesophagusinendoscopy.