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Objective To investigate the diagnostic value of Lugol solution staining combined with nar-row band imaging (NBI)for esophageal cancer and precancerous lesions.Methods From December 201 3 to December 2014,1 87 patients who were with suspicious esophageal lesions and stained with Lugol solution under endoscopy were selected as control group,while from January 2015 to June 2015,124 patients who were with sus-picious esophageal lesions and examined with Lugol solution staining and NBI under endoscopy were selected as observation group.The sensitivity,specificity and accuracy between the two groups were compared and analyzed. Results One hundred and four cases (75.0%)were found among observation group,which was higher than 93 cases (55.6%)among control group (χ2 =12.07,P <0.01 ).The total detection rates of esophageal cancer and high grade intraepithelial neoplasia (HGN)were 29.0% and 17.7% in observation group respectively,which were higher than 1 8.2% and 6.4% in control group (χ2 =4.15,P =0.04;χ2 =8.54,P <0.01 ).The Kappa value in observation group was 0.55,which was higher than 0.36 in control group.The sensitivity and accuracy in observation group were 89.9% and 82.3% respectively,which were significantly higher than 71 .8% and 68.4% in control group (χ2 =9.79,P <0.01 ;χ2 =7.38,P <0.01 ).Conclusion The sensitivity and accuracy of endoscopic Lugol solution staining combined with NBI for esophageal cancer and precancerous lesions are higher than Lugol solution staining,and it is worthy to popularize the application of Lugol solution staining com-bined with NBI in diagnosing esophageal cancer and precancerous lesions.
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Objective To investigate the diagnostic value of chromoendoscopy combined with EpCAM detection in Barrett′s e-sophagus .Methods 95 patients diagnosed BE under routine endoscopy were recruited in the study ,and in which 49 patients were stained by 2% Lugol′s solution and undergone biopsy as group A ;46 patients were undergone biopsy by routine endoscopy as group B .The expressions of EpCAM were also detected by immunohistochemical SP methods in biopsies of group A .Results 39 patients were diagnosed BE by routine histology in group A ,in which 15 Colonic type metaplasia of BE were found ,an EpCam expression was observed in 28 Barrett′s esophagus patients conformed by histology with HE staining .And 23 patients were diagnosed BE by routine histology in group B ,in which 8 Colonic type metaplasia of BE were found .Both diagnostic rate of BE and colonic type meta-plasia of BE were significantly different between group A and B .Conclusion Targeted biopsies directed by Lugol′s solution staining can improve the diagnostic rate of Barrett′s esophagus ,and diagnostic rate of colonic type metaplasia of BE can be improved fatherly by detecting the expression of EpCAM .
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Chromoendoscopy using Lugol's iodine solution is widely used to improve the detection of esophageal dysplasia or early squamous carcinoma. Although the solution helps to notice esophageal lesions and to delineate the lesions more clearly, it can cause mucosal irritation leading to retrosternal pain and epigastric discomfort infrequently. We report a case of acute gastric mucosal injury after application of Lugol's solution during chromoendoscopy in a 63-year-old woman.
Subject(s)
Female , Humans , Middle Aged , Carcinoma, Squamous Cell , Endoscopy , Iodides , Iodine , Mucous MembraneABSTRACT
Objective To study the role of Lugol staining for detecting early esophageal cancer and precancerous lesions.Methods 2% Lugol solution was adopted to stain esophageal mucosa in 45 cases with esophageal suspicious lesions,observed and multiple biopsies were taken for pathological study.Results Thirty-nine cases were light or non-stained among the 45 cases with Lugol staining.Which revealed 8 esophageal cancers(5 early cancer,3 advanced cancer),5 Barrett esophagus,,11 mild-moderate dysplasias.The rate of detecting early esophageal cancer and precancerous lesions with Lugol staining was 46.7%.Conclusion Lugol staining is helpful for diagnosis of early esophageal cancer and precancerous lesions,and it is simple in operating.The role of Lugol staining in detecting early esophageal cancer and precancerous lesions has important clinical value.
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BACKGROUND AND OBJECTIVES : Second primary esophageal cancer has been reported to comprise 6-9% of head and neck cancer cases, which are frequently detected in the advanced stage. Thus, detecting esophageal cancer in the early stage is important in the prognosis of head and neck cancer. However, it is difficult to detect early lesions using the conventional endoscopy. In the current study, the feasibility of endoscopic screening using Lugol's solution was assessing for detecting early esophageal cancer in patients of head and neck cancer. SUBJECTS AND METHOD : Sixty-two patients (Group I-synchronous cancer study group) diagnosed with head and neck cancer between November, 2003 and November, 2004 were prospectively studied. Fortysix patients (Group II-metachronous cancer study group) under the follow-up care with head and neck cancer during the same period were also evaluated. The esophagus was initially observed under direct endoscopic view and then Lugol dye was sprayed at the esophagus. Any unstained area was biopsied. RESULTS : Of 34 patients (54.8%) with unstained lesions in Group I, 10 (16.1%) showed dysplasia and 4 (6.4%) had cancer. Of 21 patients (45.6%) with unstained lesions in Group II, 2 (4.3%) showed dysplasia and 5 (10.8%) had cancer. Among 9 (8.3%) second primary esophageal cancer, 6 were detected with superficial esophageal cancer while the other 3 were found to be in the advanced stage of cancer. This superficial cancer revealed nonspecific mucosal findings in the direct endoscopic view and was difficult to be visualized as a pathologic lesion; however, it revealed unstained areas when Lugol's solution was sprayed, thus could be diagnosed as cancer through biopsy of the area. CONCLUSION : Endoscopy of esophagus with Lugol's solution could be highly effective as a screening method to detect second primary esophageal cancer in patients with head and neck cancer.
Subject(s)
Humans , Biopsy , Endoscopy , Esophageal Neoplasms , Esophagus , Follow-Up Studies , Head and Neck Neoplasms , Head , Mass Screening , Prognosis , Prospective StudiesABSTRACT
Objective To evaluate the role of Lugol’s s taining in detecting early esophageal cancer.Methods 2% Lugol’s solution was adopted to stain esophageal m ucosa in 111 cases with esophageal superficial lesions. And multiple biopsies we re taken for pathological study.Results Among the 111 cases with Lugol’s staining, the results in normal, light, deep and non-stained were 4, 68,11 and 28 cases respectively . Pathology result: no cases of esophageal cancer or cell dysplasia in normal an d deep stained groups, 3 cases of severe dysplasia and 1 case of canceration in light stained group, 17 cases of esophageal squamous cell carcinoma and 5 cases of severe dysplasia in un-stained group.Conclusion The cancerous and precancerous lesions are liable to occur in cases with non- and light Lugol’s staining groups. The rate of detec ting early esophageal cancer increased when Lugol’s staining and biopsy are use d in combination.