| Abstract: | The present study assessed whether or not acetic acid‐enhanced‐magnification endoscopy was practical for the detection of mucosal cancer as well as intestinal metaplasia. Fifty‐three patients (40 men, 13 women; median age 60.8 years) with columnar‐lined esophagus were enrolled in a prospective trial of enhanced‐magnification endoscopy after instillation of 1.5% acetic acid. Each enhanced‐magnification endoscopic mucosal pattern was classified as one of six types: type I, small round pits of uniform size and shape; II, slit‐reticular pattern; IIIa, gyrus pattern; IIIb, villous pattern; IV, irregular granular pattern and V, minute grain‐like pattern. Two adenocarcinomas were found in two patients and intestinal metaplasia was found in 26 of the 52 patients (50.0%); 12 of 25 (48.0%) were < 1 cm, seven of 18 (38.9%) were 1–2 cm, three of five (60.0%) were 2–3 cm and four of four (100%) were > 3 cm. A total of 115 biopsy specimens were obtained from enhanced‐magnified areas. Three of three areas (100%) showing type V and two of two areas (100%) showing type IV were adenocarcinoma. Twenty‐four (71%) of 34 areas indicating type IIIa were intestinal metaplasias and 10 (29%) showed cardiac mucosa. Nine of 10 (90%) of type IIIb were intestinal metaplasias; 45 (82%) of 55 type II specimens showed cardiac mucosa and eight (15%) were intestinal metaplasias. Eleven of 11 (100%) type I specimens showed fundic mucosa. Acetic acid‐enhanced‐magnification endoscopy was effective for the diagnosis of adenocarcinomas as well as intestinal metaplasia in Barrett’s esophagus. |
