INTESTINAL METAPLASIA SUBTYPING - EVALUATION OF GOMORIS ALDEHYDE FUCHSIN FOR ROUTINE DIAGNOSTIC USE

Aims: Intestinal metaplasia (IM) has been implicated in the pathogenes is of gastro-oesophageal carcinoma, but because of its common occurren ce, its specificity for use in cancer surveillance is low. IM subtypes characterized by mucin phenotype have been studied to try and improve specificity. Methods and results: On balance, type III IM seems the m ost promising for use in gastric cancer surveillance. The situation is problematic at the gastro-oesophageal junction where the normal occur rence of acidic mucins raises doubt on the value of subtyping. High ir on diamine-Alcian blue combination (HID-AB) is commonly used for IM su btyping, but its potential toxicity and long staining period (up to 24 hours) precludes widespread clinical use. This study has compared the sulphomucin staining ability of Gomori's aldehyde fuchsin-Alcian blue combination (GAF-AB) against HID-AB for identifying and subtyping LM in gastric and oesophageal biopsies. Conclusions: Compared to HID-AB, a sensitivity of 85%, a specificity of 100% and a staining time of les s than 30 minutes, shows this stain to be a simple and effective techn ique for identifying and subtyping IM in routine laboratories.