The importance of magnification chromoendoscopy with methylene blue in detecting specialized intestinal metaplasia in short segment Barrett’s esophagus

Background:S pecialized intestinal metaplasia (SIM) is not identifiable in Barrett esophagus in standard white light endoscopy. In thisstudy we assessed the utility of magnification chromoendoscopy with methylene blue in detecting SIM in patients with short Barrett’s esophagus.Material and method: The study included 50 patients with suspected short Barrett’s esophagus: 26 followed standard endoscopy with randombiopsies and 24 underwent magnification chromoendoscopy with methylene blue with targeted biopsies. In the magnification chromoendoscopygroup, magnified images were analyzed and specific patterns were classified using Endo’s classification. Results: In the standard endoscopygroup, 17 of 26 patients were detected as having SIM and in the magnification chromoendoscopy group 20 of 24 patients were SIM positive.Magnification chromoendoscopy increases the probability of detecting SIM up to 2,4 times (OR=2.39, p=0.028). Sensitivity and specificity ofMB staining in diagnosis of SIM was 78.7% and 55.5%. SIM was diagnosed in areas with tubular and villous patterns, but had a significantcorrelation only with villous pattern (p=0.017).Conclusion: Magnification chromoendoscopy with methylene blue improves SIM detection inpatients with short Barrett’s esophagus.