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Endoscopic diagnosis of type iib early gastric cancer by the endoscopic congo red methylene blue test



Endoscopic diagnosis of type iib early gastric cancer by the endoscopic congo red methylene blue test



Stomach & Intestine (Tokyo) 16(12): 1331-1336



Two cases of type IIb early gastric cancer which were correctly diagnosed by this test are presented. The patients were given 20,000 U of pronase and 50 ml of 0.2 M sodium bicarbonate solution containing 20 mg of Gascon orally 30 min before examination; 20 min before endoscopy, 4 mg of Coliopan was injected s.c. A gastrofiberscope was then inserted and the interior of the stomach was inspected. A spray tube was inserted through the biopsy forceps channel and 0.05% methylene blue solution was sprayed over the entire surface of the gastric mucosa. After observation of the microstructure of the gastric mucosa, a mixture of 0.3% Congo red and 0.2 M sodium bicarbonate solution was sprayed over the gastric mucosa and the blue discoloration of the gastric mucosa with methylene blue was examined. An augmented dose of Tetragastrin-NS was administered and the color change of the gastric mucosa was observed through the gastrofiberscope. In this test, gastric cancer bleached the Congo red and methylene blue sprayed over its surface; this appeared in sharp contrast to the red mucosa of unaffected areas. The spread of cancerous growth could be judged rather accurately and the target area can be reached by biopsy in cases where there are a few, if any, visual signs of abnormality. By routine endoscopic examination, correct diagnoses were obtained in 85.0% of type IIb lesions of .ltoreq. 10 mm in diameter, but it was impossible to determine endoscopically type IIb lesions of < 10 mm in diameter. The endoscopic Congo red-methylene blue test made possible accurate determination of typical type IIb lesions of < 10 mm in diameter.

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Accession: 005359196

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