Abstract
With methylene blue dye spraying endoscopy with aids of biopsy study, we investigated changes of fundic-pyloric (F-P) border and the incidence and/or extension of the stained phenomenon of gastric mucosa in 176 healthy control subjects. The obtained results were as follows; 1) The F-P border shifted cephalad with age, but the unchanged F-P border remained in 35.7% of the subjects in the sixties, more frequent than in the fourties or fifties. 2) The stained mucosa with methylene blue, that is, metaplastic mucosa of the stomach spread and increased in its frequency with age, but the unstained mucosa remained in 35.7% of the subjects in the sixties. 3) By the dye spraying endoscopy fifty cases were followed for two years and 32 cases for four years. The F-P border advanced in 10 of 50 cases (20.0%) for two years, and in 9 of 32 cases (28.1%) for four years. Upward extension of the F-P border were frequent in the thirties and sixties. 4) Our endoscopic follow-up observation showed changes in the extension and degree of the stained mucosa with methylene blue in 10 of 50 cases (20.0%) for two years and in 12 of 32 cases (37.5%) for four years. In 7 cases the stained mucosa was newly diagnosed. The stained area, that is, intestinal metaplasia commonly arose on the lesser curvature of the antrum. 5) Our endoscopic follow-up study also indicated that the staining type of intestinal metaplasia developed from the depressed type to the elevated one, and the staining degree advanced from the scattered type to the diffuse one. 6) Changes in the F-P border and/or methylene blue staining were noticed in 18 of 50 cases (36.0%) for two years and in 17 of 32 cases (53.1%) for four years. In addition, our follow-up data indicate that intestinal metaplasia is likely to arise mainly from the pyloric gland area, or from the fundic gland area following pyloric metaplasia.
