Lugol Chromoendoscopy Detects Esophageal Dysplasia With Low Levels of Sensitivity in a High-Risk Region of China

Lugol’s Chromoendoscopy in the Screening of Esophageal Squamous Cell Carcinoma: Time to Take a Closer Look?

“…Our own data from an international trial evaluating low-cost high-resolution microendoscopy plus LCE versus LCE alone showed a per-biopsy sensitivity of 97% and a per-patient sensitivity of 100% with LCE alone for the detection of high-grade dysplasia or ESCC. 12 The results from Li et al 6 are therefore intriguing, and a significant departure from all prior studies.…”

“…The most prominent prior study evaluating the sensitivity of LCE for squamous dysplasia and ESCC was done by Dawsey et al 7 in Linxian, China, which is also referenced by Li et al 6 in their current study. In the Linxian study, the reported sensitivity of LCE for the diagnosis of high-grade dysplasia or carcinoma was 96%.…”

“…This results in normal areas being intensely stained by the Lugol solution, whereas dysplastic areas typically have reduced or completely absent iodine staining. 5 In this issue of Clinical Gastroenterology and Hepatology, Li et al 6 report on the results of their study evaluating the sensitivity of LCE for the detection of esophageal dysplasia, which was conducted as part of a larger population-based randomized controlled trial on screening for ESCC in Hua County in northern China.…”

Clinical Significance of Monitoring Circulating Free DNA and Plasma Heat Shock Protein 90alpha in Patients with Esophageal Squamous Cell Carcinoma

“…Due to the late-stage at diagnosis for most patients, the prognosis of ESCC patients remains poor, with an overall 5-year survival rate of 15-25% [4,5]. Massive efforts have been made to develop diverse methods to detect early cancer, monitor treatment response and predict prognosis [6][7][8][9][10]. To date, nevertheless, works to indentify molecular markers in association with the pathogenesis and response to therapy of ESCC have proved to be essentially unsuccessful [11].…”

Lack of Iodine Staining Lugol’s Chromoendoscopy Predicts Squamous Neoplastic Progression in a High-risk Region of China: Implications for East and West

“…[10][11][12] Two large studies have shown a high sensitivity of LCE compared with biopsy for severe squamous dysplasia and ESCC in high-risk regions of China. 13,14 In this issue of Clinical Gastroenterology and Hepatology, an insightful analysis within the intervention arm of an ongoing, large, cluster-randomized, controlled trial from Lui et al 15 in the Hua county region of China (a high-risk region for ESCC), has contributed significantly to the prior literature in elucidating the testing characteristics of Lugol chromoendoscopy for ESCC and dysplasia in the Asian esophageal cancer belt. The authors found that participants with unstained areas on LCE but biopsies without squamous dysplasia had a higher rate of progression to severe squamous dysplasia, squamous carcinoma in situ, or invasive squamous cell carcinoma than those with mild or moderate dysplasia on nontargeted biopsy and the absence of unstained lesions on Lugol iodine staining.…”