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The purpose of endoscopy in diagnosis and surveillance of Barrett esophagus (BE) is to detect dysplasia and identify patients at high risk for esophageal adenocarcinoma. Many groups have evaluated chromoendoscopy with various dyes as an adjunct for identifying dysplastic areas of BE. The dye methylene blue (MB) has been used to identify dysplasia and metaplasia, particularly in short-segment BE. This dye is taken up by absorbent intestinal-type epithelia, whereas squamous epithelia and dysplastic BE cells take up little, resulting in heterogeneous staining.
In this prospective, crossover study, 35 patients with BE and prior diagnoses of dysplasia were randomized to MB-directed biopsy (MBDB) or to random 4-quadrant biopsies in the first of tw…