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Chromoendoscopy
Chromoendoscopy is a medical procedure wherein dyes are instilled into the gastrointestinal tract at the time of visualization with fibre-optic endoscopy. The purposes of chromoendoscopy is chiefly enhance the characterization of tissues, although dyes may be used for other functional purposes. The detail achieved with chromoendoscopy can often allow for identification of the tissue type or pathology based upon the pattern uncovered.
==Varieties of stains==
Stains used in chromoendoscopy have three major mechanisms. Absorptive stains have an affinity for particular mucosal elements, and include Lugol's iodine, methylene blue, toluidine blue and crystal violet (gentian violet) . Lugol's iodine specifically stains non-keratinized squamous epithelium, and consequently is useful for identifying squamous tissue, squamous dysplasia and squamous cell carcinomas. Methylene blue stains absorptive epithelium and is useful for identifying abnormality in the small intestine and colon. Barrett's esophagus involves change in the mucosa of the esophagus into a tissue that includes glands (intestinal metaplasia), and as a result, can be identified with methylene blue staining. Also, methylene blue has been used to identify dysplasia in patients with ulcerative colitis.〔 Toluidine blue stains nuclei of malignant cells blue, and is used in oral and esophageal squamous cell carcinoma. Crystal violet is absorbed into intestinal and neoplastic cells and is used to identify Barrett's esophagus and colonic neoplasms.
Contrast stains are not absorbed but rather provide contrast by permeating between irregularities in the mucosa to highlight irregularities. The primary contrast stain is indigo carmine, administered at varying concentrations between 0.1% and 0.8%. The chief utility of indigo carmine is in the identification of dysplastic cells in individuals with chronic ulcerative colitis.
Reactive stains undergo an observable change due to a chemical process related to the function of the gastrointestinal tract. Congo red is used as a test for achlorhydria in the stomach, to test adequacy of vagotomy ( post adequate vagotomy, gastric acid secretion is abolished) and to detect presence of ectopic gastric tissue, as it changes colour from red to black at a pH less than 3. Should acid not be present in the stomach, it would remain red.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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