Endoscopy 1999; 31(6): 479-486
DOI: 10.1055/s-1999-8041
Review
Georg Thieme Verlag Stuttgart ·New York

Staining in Gastrointestinal Endoscopy: The Basics

 M. I. Canto
  • Division of Gastroenterology and Endoscopy, Johns Hopkins University School of Medicine, Baltimore, USA
Further Information

Publication History

Publication Date:
31 December 1999 (online)

Introduction

Chromoendoscopy or tissue staining is an “old” endoscopic technique that has been used for decades. It involves the topical application of stains or pigments to improve localization, characterization, or diagnosis [1]. It is a useful adjunct to endoscopy; the contrast between normally stained and abnormally stained epithelium enables the endoscopist to formulate a diagnosis and/or to direct biopsies based on a specific reaction or enhancement of surface morphology. In recent years, there has been a resurgence of interest in chromoendoscopy as an endoscopic technique that can improve endoscopic diagnosis. This may have occurred because it is a simple, safe, quick, widely available, and inexpensive diagnostic tool. Also, new applications of staining techniques to the diagnosis of conditions such as Barrett's esophagus, celiac sprue, and the presence of Helicobacter pylori underscore the potential for routine clinical use by the gastroenterologist. Vital staining and tattooing have become even more relevant in clinical gastrointestinal practice because of evolving endoscopic therapies (such as endoscopic mucosal resection, photodynamic therapy, multipolar electrocoagulation, etc.) which require careful selection of patients suitable for treatment.

References

  • 1 Fennerty M B. Tissue staining.  Gastrointest Endosc Clin N Am. 1994;  4 297-311
  • 2 Chisholm E M, Williams S R, Leung J W, Chung S C, et al. Lugol's iodine dye-enhanced endoscopy in patients with cancer of the oesophagus and head and neck.  Eur J Surg Oncol. 1992;  18 550-552
  • 3 Okumura T, Aruga H, Inohara H, et al. Endoscopic examination of the upper gastrointestinal tract for the presence of second primary cancers in head and neck cancer patients.  Acta Otolaryngol Suppl. 1993;  501 103-106
  • 4 Yokoyama A, Ohmori T, Makucchi H, et al. Successful screening for early esophageal cancer in alcoholics using endoscopy and mucosa iodine staining (see comments).  Cancer. 1995;  76 928-934
  • 5 Woolf G M, Riddell R H, Irvine E J, Hunt R H. A study to examine agreement between endoscopy and histology for the diagnosis of columnar lined (Barrett's) esophagus.  Gastrointest Endosc. 1989;  35 541-544
  • 6 Herlin P, Marnay J, Jacob J, et al. A study of the mechanism of the toluidine blue dye test.  Endoscopy. 1983;  15 4-7
  • 7 Seitz J, Monges G, Navarro P, et al. Endoscopic detection of dysplasia and early esophageal cancer: results of a prospective study with toluidine blue staining in 100 tobacco and alcohol abusers.  Gastroenterol Clin Biol. 1990;  14 15-21
  • 8 Hix W R, Wilson W R. Toluidine blue staining of the esophagus. A useful adjunct in the panendoscopic evaluation of patients with squamous cell carcinoma of the head and neck.  Arch Otolaryngol Head Neck Surg. 1987;  113 864-865
  • 9 Contini S, Consigli G F, Di Lecce F, et al. Vital staining of oesophagus in patients with head and neck cancer: still a worthwhile procedure.  Ital J Gastroenterol. 1991;  23 5-8
  • 10 Giler S, Kadish U, Urca I. Use of tolonium chloride in the diagnosis of malignant gastric ulcers.  Arch Surg. 1978;  113 136-139
  • 11 Chobanian S J, Cattau E L, Winters C. In vivo staining with toluidine blue as an adjunct to the endoscopic detection of Barrett's esophagus.  Gastrointest Endosc. 1987;  33 99-101
  • 12 Niveloni S, Fiorini A, Dezi R, et al. Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement (see comments).  Gastrointest Endosc. 1998;  47 223-229
  • 13 Fennerty M B, Sampliner R E, McGee D L, et al. Intestinal metaplasia of the stomach: identification by a selective mucosal staining technique (see comments).  Gastrointest Endosc. 1992;  38 696-698
  • 14 Ida K, Hashimoto Y, Takeda S, et al. Endoscopic diagnosis of gastric cancer with dye scattering.  Am J Gastroenterol. 1975;  63 316-320
  • 15 Tatsuta M, Iishi H, Okuda S, Taniguchi H. Diagnosis of early gastric cancers in the upper part of the stomach by the endoscopic Congo red-methylene blue test.  Endoscopy. 1984;  16 131-134
  • 16 Canto M I, Setrakian S, Petras R E, et al. Methylene blue selectively stains intestinal metaplasia in Barrett's oesophagus.  Gastrointest Endosc. 996;  44 1-7
  • 17 Suzuki S, Murakami H, Suzuki H, et al. An endoscopic staining method for detection and operation of early gastric cancer.  Int Adv Surg Oncol. 1979;  2 223-241
  • 18 Canto M, Setrakian S, Willis J, et al. Methylene blue staining of dysplastic and nondysplastic Barrett's esophagus: an in vivo and ex vivo study (abstract).  Gastrointest Endosc. 1996;  43 164
  • 19 Futura Y, Kobori O, Shimazu H, et al. A new in vivo staining method, cresyl violet staining, for fiberoptic magnified observation of carcinoma of the gastric mucosa.  Gastroenterol Jpn. 1985;  20 120-124
  • 20 Stevens P D, Lightdale C J, Green P H, et al. Combined magnification endoscopy with chromoendoscopy for the evaluation of Barrett's esophagus.  Gastrointest Endosc. 1994;  40 747-749
  • 21 Siegel L M, Stevens P D, Lightdale C J, et al. Combined magnification endoscopy with chromoendoscopy in the evaluation of patients with suspected malabsorption.  Gastrointest Endosc. 1997;  46 226-230
  • 22 Axelrad L M, Fleischer D E, Geller A J, et al. High-resolution chromoendoscopy for the diagnosis of diminutive colon polyps: implications for colon cancer screening.  Gastroenterology. 1996;  110 1253-1258
  • 23 Kudo S, Kashida H, Nakajima T, et al. Endoscopic diagnosis and treatment of early colorectal cancer.  World J Surg. 1997;  21 694-701
  • 24 Jaramillo E, Watanabe M, Slezak P, Rubio C. Flat neoplastic lesions of colon and rectum detected by high-resolution video endoscopy and chromoscopy (see comments).  Gastrointest Endosc. 1995;  42 114-122
  • 25 Ikeda K, Sannohe Y, Araki S, Inutsuka S. Intra-aterial dye method with vasomotors (PIAD method) applied for the endoscopic diagnosis of gastric cancer and the side effects of indigo carmine.  Endoscopy. 1982;  14 119-123
  • 26 Donahue P, Bombeck C, Yoshida Y, Nyhus L. The simplified endoscopic congo red test for completeness of vagotomy.  Surg Gynecol Obstet. 1986;  163 287-289
  • 27 Kohli Y, Kato T, Ito S. Helicobacter pylori and chronic atrophic gastritis.  J Gastroenterol. 1994;  7 105-109
  • 28 Coyle W J, Lawson J M. Helicobacter pylori infection in patients with early gastric cancer by the endoscopic phenol red test.  Gastrointest Endosc. 1998;  48 327-328
  • 29 Iseki K, Tatsuta M, Iishi H, et al. Helicobacter pylori infection in patients with early gastric cancer by the endoscopic phenol red test (published erratum appears in Gut 1998: 42; 450).  Gut. 1998;  42 20-23
  • 30 Hyman N, Waye J. Endoscopic four quadrant tattoo for the identification of colonic lesions at surgery.  Gastrointest Endosc. 1991;  37 56-58
  • 31 Shatz B A, Weinstock L B, Swanson P E, Thyssen E P. Long-term safety of India ink tattoos in the colon.  Gastrointest Endosc. 1997;  45 153-156
  • 32 Shaffer R T, Francis J M, Carroughter J G, et al. India ink tattooing in the esophagus.  Gastrointest Endosc. 1998;  47 257-260
  • 33 Nizan R, Siddiqi N, Landas S K, et al. Colonic tattooing with India ink: benefits, risks, and alternatives.  Am J Gastroenterol. 1996;  91 1804-1808
  • 34 Gallo R, Parodi A, Cozzani E, Guarrera M. Allergic reaction to India ink in a black tattoo.  Contact Dermatitis. 1998;  38 346-347
  • 35 Coman E, Brandt L J, Brenner S, et al. Fat necrosis and inflammatory pseudotumor due to endoscopic tattooing of the colon with India ink (see comments).  Gastrointest Endosc. 1991;  37 65-68
  • 36 Park S I, Genta R S, Romeo D P, Weesner R E. Colonic abscess and focal peritonitis secondary to India ink tattooing of the colon (see comments).  Gastrointest Endosc. 1991;  37 68-71
  • 37 Lane K L, Vallera R, Washington K, Gottfried M R. Endoscopic tattoo agents in the colon. Tissue responses and clinical implications.  Am J Surg Pathol. 1996;  20 1266-1279

MHS M.D. M. I. Canto

Division of Gastroenterology and Hepatology The Johns Hopkins Hospital

1830 E. Monument Street, Room 425

Baltimore

Maryland 21205

USA

Phone: + 1-410-614-2490

Email: mcanto@welch.jhu.edu