Methylene Blue Chromoendoscopy in Barrett's Esophagus

NCT ID: NCT00587652

Last Updated: 2010-01-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2002-12-31

Study Completion Date

2009-12-31

Brief Summary

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This study is being done to:

Determine if a temporary dye applied to the esophagus identifies areas of dysplasia (pre-cancer). Determine if certain dye patterns indicate specific grades of dysplasia. Determine if overall endoscopy costs can be reduced with this dye technique. Determine if the dye could allow fewer biopsies to be obtained in the future.

Detailed Description

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Although methylene blue has been used effectively to identify areas of SIM in several studies, its superiority in identifying dysplasia in the setting of Barrett's esophagus has been inconclusive. In all studies to date dysplastic yield was equivalent or better than protocol techniques while requiring fewer biopsies. Variations in study design, staining technique and inexperience in staining interpretation are some of the reasons. Our goal is to build on the techniques that have been shown to be effective, standardize them for the purposes of our study, and to objectively evaluate if MB directed biopsies are useful in screening Barrett's patients for dysplasia. At the time of EGD when length of Barrett's is determined, patients will be stratified into either intermediate (2-4cm) or long segment (\>4cm) Barrett's. Short segment Barrett's esophagus patients will not be considered, as MB techniques have not proved beneficial in dysplasia detection as previously described 7.

Conditions

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Barrett Esophagus

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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1

Intermediate Segment Barrett's (2-4cm)

No interventions assigned to this group

2

Long segment Barrett's (\>4 cm)

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* History of Barrett's with or without dysplasia
* Able to give consent

Exclusion Criteria

* Pregnancy or women of child-bearing potential
* Active esophagitis
* Esophageal varices
* Esophageal cancer (history of or current)
* Hypersensitivity to methylene blue
* Severe renal impairment (creatinine\>2.0)
* Known glucose-6-phosphate dehydrogenase (G-6-PD) deficiency
* Symptomatic coronary artery disease
* Coagulopathy (INR\>/=1.5)
* Thrombocytopenia \</= 20K/ul
* Previous esophageal ablative therapy (EMR,PDT, APC)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AstraZeneca

INDUSTRY

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Mayo Clinic

Principal Investigators

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Christopher G Gostout, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic, Rochester, MN

Locations

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Mayo Clinic

Rochester, Minnesota, United States

Site Status

Countries

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United States

References

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Rajan E, Burgart LJ, Gostout CJ. Endoscopic and histologic diagnosis of Barrett esophagus. Mayo Clin Proc. 2001 Feb;76(2):217-25. doi: 10.1016/S0025-6196(11)63133-9.

Reference Type BACKGROUND
PMID: 11213314 (View on PubMed)

Gopal DV. Another look at Barrett's esophagus. Current thinking on screening and surveillance strategies. Postgrad Med. 2001 Sep;110(3):57-8, 61-2, 65-8. doi: 10.3810/pgm.2001.09.1018.

Reference Type BACKGROUND
PMID: 11570206 (View on PubMed)

Canto MI, Setrakian S, Petras RE, Blades E, Chak A, Sivak MV Jr. Methylene blue selectively stains intestinal metaplasia in Barrett's esophagus. Gastrointest Endosc. 1996 Jul;44(1):1-7. doi: 10.1016/s0016-5107(96)70221-3.

Reference Type BACKGROUND
PMID: 8836709 (View on PubMed)

Weston AP, Krmpotich PT, Cherian R, Dixon A, Topalosvki M. Prospective long-term endoscopic and histological follow-up of short segment Barrett's esophagus: comparison with traditional long segment Barrett's esophagus. Am J Gastroenterol. 1997 Mar;92(3):407-13.

Reference Type BACKGROUND
PMID: 9068459 (View on PubMed)

Fennerty MB, Sampliner RE, McGee DL, Hixson LJ, Garewal HS. Intestinal metaplasia of the stomach: identification by a selective mucosal staining technique. Gastrointest Endosc. 1992 Nov-Dec;38(6):696-8. doi: 10.1016/s0016-5107(92)70567-7. No abstract available.

Reference Type BACKGROUND
PMID: 1282115 (View on PubMed)

Canto MI. Vital staining and Barrett's esophagus. Gastrointest Endosc. 1999 Mar;49(3 Pt 2):S12-6. doi: 10.1016/s0016-5107(99)70518-3. No abstract available.

Reference Type BACKGROUND
PMID: 10049441 (View on PubMed)

Canto MI, Setrakian S, Willis J, Chak A, Petras R, Powe NR, Sivak MV Jr. Methylene blue-directed biopsies improve detection of intestinal metaplasia and dysplasia in Barrett's esophagus. Gastrointest Endosc. 2000 May;51(5):560-8. doi: 10.1016/s0016-5107(00)70290-2.

Reference Type BACKGROUND
PMID: 10805842 (View on PubMed)

Kiesslich R, Hahn M, Herrmann G, Jung M. Screening for specialized columnar epithelium with methylene blue: chromoendoscopy in patients with Barrett's esophagus and a normal control group. Gastrointest Endosc. 2001 Jan;53(1):47-52. doi: 10.1067/mge.2001.111041.

Reference Type BACKGROUND
PMID: 11154488 (View on PubMed)

Sharma P, Topalovski M, Mayo MS, Weston AP. Methylene blue chromoendoscopy for detection of short-segment Barrett's esophagus. Gastrointest Endosc. 2001 Sep;54(3):289-93. doi: 10.1067/mge.2001.115728.

Reference Type BACKGROUND
PMID: 11522967 (View on PubMed)

Canto MI, Yoshida T, Gossner L. Chromoscopy of intestinal metaplasia in Barrett's esophagus. Endoscopy. 2002 Apr;34(4):330-6. doi: 10.1055/s-2002-23640. No abstract available.

Reference Type BACKGROUND
PMID: 11932792 (View on PubMed)

Canto MI. Methylene blue chromoendoscopy for Barrett's esophagus: coming soon to your GI unit? Gastrointest Endosc. 2001 Sep;54(3):403-9. doi: 10.1067/mge.2001.117958. No abstract available.

Reference Type BACKGROUND
PMID: 11522995 (View on PubMed)

Wo JM, Ray MB, Mayfield-Stokes S, Al-Sabbagh G, Gebrail F, Slone SP, Wilson MA. Comparison of methylene blue-directed biopsies and conventional biopsies in the detection of intestinal metaplasia and dysplasia in Barrett's esophagus: a preliminary study. Gastrointest Endosc. 2001 Sep;54(3):294-301. doi: 10.1067/mge.2001.115732.

Reference Type BACKGROUND
PMID: 11522968 (View on PubMed)

Tabuchi M, Sueoka N, Fujimori T. Videoendoscopy with vital double dye staining (crystal violet and methylene blue) for detection of a minute focus of early stage adenocarcinoma in Barrett's esophagus: a case report. Gastrointest Endosc. 2001 Sep;54(3):385-8. doi: 10.1067/mge.2001.116458. No abstract available.

Reference Type BACKGROUND
PMID: 11522988 (View on PubMed)

Gangarosa LM, Halter S, Mertz H. Methylene blue staining and endoscopic ultrasound evaluation of Barrett's esophagus with low-grade dysplasia. Dig Dis Sci. 2000 Feb;45(2):225-9. doi: 10.1023/a:1005479619246.

Reference Type BACKGROUND
PMID: 10711429 (View on PubMed)

Breyer HP, Silva De Barros SG, Maguilnik I, Edelweiss MI. Does methylene blue detect intestinal metaplasia in Barrett's esophagus? Gastrointest Endosc. 2003 Apr;57(4):505-9. doi: 10.1067/mge.2003.137.

Reference Type BACKGROUND
PMID: 12665760 (View on PubMed)

Montgomery E, Bronner MP, Goldblum JR, Greenson JK, Haber MM, Hart J, Lamps LW, Lauwers GY, Lazenby AJ, Lewin DN, Robert ME, Toledano AY, Shyr Y, Washington K. Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. Hum Pathol. 2001 Apr;32(4):368-78. doi: 10.1053/hupa.2001.23510.

Reference Type BACKGROUND
PMID: 11331953 (View on PubMed)

Katzka DA, Rustgi AK. Gastroesophageal reflux disease and Barrett's esophagus. Med Clin North Am. 2000 Sep;84(5):1137-61. doi: 10.1016/s0025-7125(05)70280-7.

Reference Type BACKGROUND
PMID: 11026922 (View on PubMed)

Canto MI, Setrakian S, Willis JE, Chak A, Petras RE, Sivak MV. Methylene blue staining of dysplastic and nondysplastic Barrett's esophagus: an in vivo and ex vivo study. Endoscopy. 2001 May;33(5):391-400. doi: 10.1055/s-2001-14427.

Reference Type BACKGROUND
PMID: 11396755 (View on PubMed)

Hackelsberger A, Gunther T, Schultze V, Manes G, Dominguez-Munoz JE, Roessner A, Malfertheiner P. Intestinal metaplasia at the gastro-oesophageal junction: Helicobacter pylori gastritis or gastro-oesophageal reflux disease? Gut. 1998 Jul;43(1):17-21. doi: 10.1136/gut.43.1.17.

Reference Type BACKGROUND
PMID: 9771400 (View on PubMed)

Goldman AI. Issues in designing sequential stopping rules for monitoring side effects in clinical trials. Control Clin Trials. 1987 Dec;8(4):327-37. doi: 10.1016/0197-2456(87)90153-x.

Reference Type BACKGROUND
PMID: 3327653 (View on PubMed)

Canto MI. Chromoendoscopy and magnifying endoscopy for Barrett's esophagus. Clin Gastroenterol Hepatol. 2005 Jul;3(7 Suppl 1):S12-5. doi: 10.1016/s1542-3565(05)00289-2.

Reference Type BACKGROUND
PMID: 16012986 (View on PubMed)

Other Identifiers

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IRUSEOMO164

Identifier Type: -

Identifier Source: secondary_id

2114-02

Identifier Type: -

Identifier Source: org_study_id

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