TOLUIDINE BLUE DYE-SPRAYING TECHNIQUE FOR THE DIAGNOSIS OF INTESTINAL METAPLASIA (ON ENDOSCOPY) OF THE STOMACH

Abstract

A diagnostic method of endoscopic toluidine blue dye-spraying technique was studied. Administration of toluidine blue did not show any toxity. When 0.05% toluidine blue solution was sprayed on the stomach, gastric mucous membrane with intestinal metaplasia showed metachromatic staining about 2 minutes after spraying. The toluidine blue dye-spraying technique did not need washing by water after spraying. The rate of correct diagnosis by toluidine blue dye-spraying technique was 77.8%. False positive cases were 22. 2%. Histological examination showed that most of metachromasia originated from staining of intracellular mucin in goblet cells by the dye absorbed in gastric mucous membrane with intestinal metaplasia. It turned out that intracellular mucin in goblet cells was mainly consisted of chondroitin sulfate B and C. This was confirmed by the histo-chemical and test tube methods using chondroitinase. Intestinal metaplasia was classified into 8 types by the toluidine blue dye-spraying technique.