Chromoendoscopy: from a research tool to clinical progress

Chromoendoscopy, the intravital staining of gastrointestinal epithelia, provides additional diagnostic information with respect to the epithelial morphology and pathophysiology. Based on experience gathered mainly in Japan, chromoendoscopy is now in more widespread use, in particular to identify preneoplastic and neoplastic lesions. The most promising techniques are the depiction of squamous epithelium neoplasia of the esophagus with Lugol's solution, staining of Barrett's mucosa by methylene blue, including the potential to identify neoplasia, and the demarcation of neoplasia with indigo carmine in stomach and colon for local endoscopic resection. However, the optimal methodology is still to be defined as well as diverging results of diagnostic accuracy to be clarified. High-resolution and magnifying endoscopy have breathed new life into chromoendoscopy. Innovative applications and refinement of the existing ones are soon to be expected.