Ichimasa Katsuro, Kudo Shin-ei, Mori Yuichi, Wakamura Kunihiko, Ikehara Nobunao, Kutsukawa Makoto, Takeda Kenichi, Misawa Masashi, Kudo Toyoki, Miyachi Hideyuki, Yamamura Fuyuhiko, Ohkoshi Shogo, Hamatani Shigeharu, Inoue Haruhiro
Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Dig Endosc. 2014 May;26(3):403-8. doi: 10.1111/den.12164. Epub 2013 Sep 10.
Endocytoscopy (EC) at ultra-high magnification enables in vivo visualization of cellular atypia of gastrointestinal mucosae. Clear images are essential for precise diagnosis by EC. The aim of the present study was to evaluate the optimal staining method for EC in the colon.
Thirty prospectively enrolled patients were allocated 1:1:1 to three distinct staining methods: 0.05% crystal violet (CV) alone, 1% methylene blue (MB) alone, or CV+MB (CM double). Normal rectal mucosae were stained with each dye and videos of EC images were recorded. Visibility of nuclei and gland formation after staining were evaluated as 'recognizable' or 'not recognizable'. Time for each parameter to become 'recognizable' was measured, and the average times for the three staining regimens were compared.
MB alone and CM double staining resulted in 'recognizable' (102 ± 27 vs 89 ± 22 s, P=0.263) nuclei within comparable periods of time, whereas CV alone was unable to identify nuclei. Gland formation became 'recognizable' sooner after CM double staining than after MB alone (61 ± 16 vs 108 ± 24 s, P<0.001).
Double staining with CV and MB, which rapidly provided recognizable images of both nuclei and gland formation, is an appropriate staining regimen for colonic EC.
超高倍放大的内镜检查术（EC）能够在体内观察胃肠道黏膜的细胞异型性。清晰的图像对于EC的精确诊断至关重要。本研究的目的是评估结肠EC的最佳染色方法。
将30例前瞻性纳入的患者按1:1:1分配至三种不同的染色方法：单独使用0.05%结晶紫（CV）、单独使用1%亚甲蓝（MB）或CV+MB（CM双重染色）。用每种染料对正常直肠黏膜进行染色，并记录EC图像的视频。将染色后细胞核和腺体形成的可见性评估为“可识别”或“不可识别”。测量每个参数达到“可识别”的时间，并比较三种染色方案的平均时间。
单独使用MB和CM双重染色在相当的时间段内使细胞核“可识别”（分别为102±27秒和89±22秒，P=0.263），而单独使用CV无法识别细胞核。CM双重染色后腺体形成比单独使用MB更快“可识别”（分别为61±16秒和108±24秒，P<0.001）。
CV和MB双重染色能快速提供可识别的细胞核和腺体形成图像，是结肠EC合适的染色方案。
