Lugol chromoendoscopic screening for esophageal dysplasia/early squamous cell carcinoma in patients with esophageal symptoms in low-risk region in China

Shao, Ying; Yu, Zhenting; Ji, Ming; Wu, Yongdong; Yu, Yong-zheng; Liang, Xiaomei; Yu, Li; Niu, Yuxin; Zhang, Shutian

doi:10.3892/ol.2015.3230

Cited by 15 publications

(11 citation statements)

References 18 publications

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“… 26 In another endoscopic screening study, 37% of the LVL > 10 mm showed dysplasia or neoplasia compared with only 5% of the LVL between 5 and 10 mm. 17 In our study, all ESPTs were ≥20 mm, whereas the six non-dysplastic lesions had a median diameter of only 6 mm. Therefore, we would suggest follow-up with repeat EGD or biopsy instead of ER in esophageal lesions smaller than 20 mm.…”

Section: Discussionmentioning

confidence: 43%

“… 13 An endoscopic screening study by Shao et al , found that 74% of the LVL showed no dysplasia on histopathological assessment. 17 Another endoscopic screening study in patients with HNSCC showed that 82% of the LVL were non dysplastic. 26 A high false positive detection rate is also reflected by our results: 46% of lesions that were suspicious on LCE were false positive, compared with 14% in NBI.…”

Section: Discussionmentioning

confidence: 99%

“…16 However, LCE is associated with a high rate of false positive lesions. 17 Combining LCE with NBI improves ESPT detection, with a reported accuracy of 91%. 18 …”

Section: Introductionmentioning

confidence: 99%

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Screening for synchronous esophageal second primary tumors in patients with head and neck cancer

Ven

Graaf

Bugter

et al. 2021

Diseases of the Esophagus

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Summary Patients with head and neck squamous cell carcinoma (HNSCC) have an increased risk of developing esophageal second primary tumors (ESPTs). We aimed to determine the incidence, stage, and outcome of synchronous ESPTs in patients with HNSCC in a Western population. We performed a prospective, observational, and cohort study. Patients diagnosed with HNSCC in the oropharynx, hypopharynx, any other sub-location in combination with alcohol abuse, or patients with two synchronous HNSCCs, between February 2019 and February 2020 underwent screening esophagogastroduodenoscopy (EGD). ESPT was defined as presence of esophageal squamous cell carcinoma (ESCC) or high grade dysplasia (HGD). Eighty-five patients were included. A lesion suspected for ESPT was detected in 14 of 85 patients, which was pathologically confirmed in five patients (1 ESCC and 4 HGD). The radiotherapy field was extended to the esophagus in two of five patients, HGD was treated with endoscopic resection in three of five patients. None of the ESPTs were detected on MRI and/or CT-scan prior to EGD. Of the remaining nine patients, three had low grade dysplasia on histology whereas the other six patients had benign lesions. Incidence of synchronous ESPT was 5.9% in our cohort of HNSCC patients. All ESPTs were diagnosed at an early stage and treated with curative intent. We recommend that screening for synchronous ESPTs should be considered in a selected group of patients with HNSCC.

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

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Screening for synchronous esophageal second primary tumors in patients with head and neck cancer

Ven

Graaf

Bugter

et al. 2021

Diseases of the Esophagus

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“…Lugol chromoendoscopy is a procedure in which Lugol's iodine is instilled into the gastrointestinal tract at the time of endoscopy. According to a study, the detection rate of esophageal dysplasia and early ESCC was 13.7% in the group of patients who underwent chromoendoscopy compared to 10.6% in the group of patients who underwent routine endoscopy ( p = 0.003) [ 13 ]. We did not perform lugol chromoendoscopy for our patient.…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Esophageal Squamous Cell Carcinoma Masquerading as Diffuse Severe Esophagitis

Abbas

Ghazanfar

Hussain

et al. 2021

Case Rep Gastroenterol

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Esophagitis is described as an inflammation of the esophagus and can result from multiple etiologies. Esophageal squamous cell carcinoma (ESCC), presenting as diffuse esophagitis in the absence of a mass or lesion, is rare. We present a case of a 61-year-old man who presented to the gastroenterology clinic for dysphagia and heartburn of 3 months duration. The patient had lost about 15 pounds unintentionally over 6 months. The patient underwent esophagogastroduodenoscopy, which revealed significant diffuse Grade 4 esophagitis without any overt bleeding. Random biopsies were taken with cold forceps from proximal, middle, and distal esophageal segments because of the striking endoscopic appearance. Histopathology revealed high-grade dysplasia and carcinoma in situ. The patient underwent endoscopic ultrasound (EUS) of the esophagus, which revealed a focal lesion. EUS-guided fine-needle aspiration showed squamous cell carcinoma of the esophagus. ESCC usually presents as a mass or a gross lesion seen on endoscopy. However, it rarely presents as severe diffuse esophagitis seen on routine endoscopy. From our observation, it would be reasonable for physicians to bear this unusual endoscopic presentation in mind and perform multiple random biopsies if encountered with such a case to rule out the possibility of any underlying malignancy.

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“…Areas with glycogen depletion such as dysplasia, squamous cell carcinoma, Barrett's epithelium, and inflammation remain unblemished or weakly stained (14) . Chromoendoscopy with Lugol's solution has improved the detection rate of squamous dysplasia and squamous cell carcinoma in early stages in patients with esophageal symptoms (reflux symptoms, dysphagia and globus sensation) compared to conventional endoscopy in both high-risk population and low risk-population (15,16) . In the study published by Shiozaki et al 178 patients with head and neck cancer were screened for synchronous and metachronous primary esophageal cancer using chromoendoscopy with Lugol's solution.…”

Section: Discussionmentioning

confidence: 99%

Chromoendoscopy Using Toluidine Blue Plus Lugol’s Solution for Early Diagnosis of Esophageal Premalignant Lesions and Superficial Neoplasms in High-Risk Patients

Piñerúa-Gonsálvez

Zambrano-Infantino

Benítez

2019

Arq. Gastroenterol.

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BACKGROUND: Esophageal cancer is the eighth most common cancer. The prognosis is bleak in patients with advanced stages. Patients with early disease have a better prognosis than those with advanced stage. There are several techniques for the screening of premalignant and superficial lesions including chromoendoscopy. OBJECTIVE: This article aimed to determine the effectiveness of chromoendoscopy with toluidine blue combined with Lugol’s solution for diagnosis of esophageal premalignant and superficial neoplastic lesions in high risk patients. METHODS: Routine white light upper endoscopy was performed. Toluidine blue was sprayed from the gastroesophageal junction to 20 cm of the dental arch. Then the uptake dye areas were characterized. Later Lugol’s solution was sprayed. Areas with less-intense staining were characterized. Biopsy of the toluidine blue capturing areas and areas with less-intense staining of Lugol’s solution were taken. In the cases where lesions were not evidenced after application of dyes, biopsies four quadrants of the esophageal mucosa were taken. The samples were evaluated by a digestive pathologist. RESULTS: Barrett’s esophagus was the most common premalignant lesion and the early neoplastic lesion was adenocarcinoma with a sensitivity of 100%, specificity 85.7%, positive predictive value 30%, negative predictive value 100%, positive likelihood ratio 7 negative likelihood ratio 0. CONCLUSION: Chromoendoscopy with toluidine blue combined with Lugol’s solution is a useful tool in the screening of esophageal premalignant lesions and superficial neoplasms.

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Lugol chromoendoscopic screening for esophageal dysplasia/early squamous cell carcinoma in patients with esophageal symptoms in low-risk region in China

Cited by 15 publications

References 18 publications

Screening for synchronous esophageal second primary tumors in patients with head and neck cancer

Screening for synchronous esophageal second primary tumors in patients with head and neck cancer

Atypical Presentation of Esophageal Squamous Cell Carcinoma Masquerading as Diffuse Severe Esophagitis

Chromoendoscopy Using Toluidine Blue Plus Lugol’s Solution for Early Diagnosis of Esophageal Premalignant Lesions and Superficial Neoplasms in High-Risk Patients

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