Diagnostic accuracy of lugol chromoendoscopy in the oesophagus in patients with head and neck cancer
Diagnostic accuracy of lugol chromoendoscopy in the oesophagus in patients with head and neck cancer
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DOI：
10.4321/s1130-01082013000200004
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发表时间：
2013-02-01
期刊：
影响因子：
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通讯作者：
Cadime, Ana Teresa
中科院分区：
文献类型：
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作者：
Carvalho, Rita;Areia, Miguel;Cadime, Ana Teresa
背景和目的：头颈部鳞状细胞恶性肿瘤患者发生食管鳞状细胞癌的风险较高。食管卢戈染色内镜是一种简单的技术，对癌前病变的诊断率高。目的是分析其诊断的准确性在异型增生和食管癌的高危patients.Methods：前瞻性研究，从2008年4月至2012年1月使用lugol色素内镜活检可疑lugol排尿区域>= 5 mm。头颈部恶性肿瘤患者包括在内，除了碘过敏，食管静脉曲张和禁忌症，以标准内镜。结果：89例患者入组（平均年龄62.8 ± 13.3岁，87%为男性）。原发于口咽部37例（41.6%），口腔29例（32.6%），喉23例（25.8%）。40.4%的患者既往接受过治疗，87%的患者报告饮酒或吸烟。所有检查均在无麻醉或并发症的情况下进行。对9个可疑的lugol排尿区进行了观察和活检。组织学分析显示2例（2.2%）高度异型增生，其余为炎症或正常结果。检测高度异型增生的敏感性和特异性分别为100%和92%（95%CI 87-97）。结论：内镜检查中食管卢戈染色是一种安全、可行的检查方法，可提高食管癌前病变的检出率。
Background and aim: patients with head and neck squamous cell malignancies have a higher risk of oesophageal squamous cell carcinomas. Lugol chromoendoscopy in oesophagus is a simple technique with a high diagnostic yield in premalignant lesions. The objective was to analyze its diagnostic accuracy in dysplasia and carcinoma of the oesophagus in high-risk patients.Methods: prospective study from April/2008 to January/2012 using lugol chromoendoscopy with biopsies of suspicious lugol voiding areas >= 5 mm. Patients with head and neck malignancies were included, except the ones with iodine allergy, oesophageal varices and contra-indications to standard endoscopy. The reference method was histopathology.Results: 89 patients were enrolled (mean age 62.8 +/- 13.3 years, 87 % men). Primary tumour was located in oropharynx in 37 (41.6 %), in oral cavity in 29 (32.6 %) and in the larynx in 23 (25.8 %) cases. 40.4% patients had previous treatments and 87 % reported alcohol or tobacco addition. All exams performed without anaesthesia or complications. Nine suspicious lugol voiding areas were observed and biopsied. Histopathological analysis revealed high-grade dysplasia in 2 (2.2 %) and inflammation or normal findings in the others. The sensitivity and specificity for detecting high-grade dysplasia were 100 % and 92 % (95 % CI 87-97), respectively. Diagnostic accuracy of the test was 92 % (95 % CI: 86-98).Conclusion: lugol staining of the oesophagus during endoscopy seems to be a feasible, safe and justified procedure in high-risk population as it enhances the detection of premalignant lesions.