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. 2012 Apr 28;18(16):1921-5.
doi: 10.3748/wjg.v18.i16.1921.

Helpfulness of the combination of acetic acid and FICE in the detection of Barrett's epithelium and Barrett's associated neoplasias

Marine Camus  1 , Romain Coriat, Sarah Leblanc, Catherine Brezault, Benoit Terris, Elise Pommaret, Marianne Gaudric, Ariane Chryssostalis, Frederic Prat, Stanislas Chaussade
Affiliations

Helpfulness of the combination of acetic acid and FICE in the detection of Barrett's epithelium and Barrett's associated neoplasias

Marine Camus et al. World J Gastroenterol. .

Abstract

Aim: To investigate the mucosal morphology in Barrett's oesophagus by chromo and magnifying endoscopy.

Methods: A prospective pilot study at a tertiary medical centre was conducted to evaluate the use of acetic acid pulverisation combined with virtual chromoendoscopy using Fujinon intelligent chromoendoscopy (FICE) for semiological characterization of the mucosal morphology in Barrett's oesophagus and its neoplastic complications. Upper endoscopy using high definition white light, 2% acid acetic pulverisation and FICE with high definition videoendoscopy were performed in 20 patients including 18 patients who presented with aspects of Barrett's oesophagus at endoscopy examination. Two patients used as controls had normal endoscopy and histological results. Prospectively, videos were watched blind from histological results by three trained FICE technique endoscopists.

Results: The videos of patients with high-grade dysplasia showed an irregular mucosal pattern in 14% using high definition white light endoscopy and in 100% using acid acetic-FICE combined. Videos did not identify irregular vascular patterns using high definition white light endoscopy, while acid acetic-FICE combined visualised one in 86% of cases.

Conclusion: Combined acetic acid and FICE is a promising method for screening high-grade dysplasia and early cancer in Barrett's oesophagus.

Keywords: Acetic acid; Barrett’s metaplasia; Chromoendoscopy; Fujinon intelligent chromoendoscopy.

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Figures

Figure 1
Figure 1
Patient selection for the present study. FICE: Fujinon intelligent chromoendoscopy.
Figure 2
Figure 2
Acetic acid and Fujinon intelligent chromoendoscopy image of the oesophagus. Specialized intestinal metaplasia using high definition white light (A), 2% acetic acid (B), and the combination of acetic acid with Fujinon intelligent chromoendoscopy (FICE) 4 (C), FICE 0 (D) and FICE 7 (E).
Figure 3
Figure 3
Acetic acid and Fujinon intelligent chromoendoscopy image of an oesophageal carcinoma. Irregular pit pattern and abnormal vascularisation is shown with 2% acetic acid (A), or following the combination of acetic acid and Fujinon intelligent chromoendoscopy (FICE) 4 (B), FICE 0 (C) and FICE 7 (D).
See this image and copyright information in PMC

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