TY - JOUR
T1 - Lugol’s iodine chromoendoscopy versus narrow band image enhanced endoscopy for the detection of esophageal cancer in patients with stenosis secondary to caustic/corrosive agent ingestion
AU - Pennachi, Caterina Maria Pia Simoni
AU - de Moura, Diogo Turiani Hourneaux
AU - Amorim, Renato Bastos Pimenta
AU - Guedes, Hugo Gonçalo
AU - Kumbhari, Vivek
AU - de Moura, Eduardo Guimarães Hourneaux
N1 - Publisher Copyright:
© 2017, IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent. All rights reserved.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background – The diagnosis of corrosion cancer should be suspected in patients with corrosive ingestion if after a latent period of negligible symptoms there is development of dysphagia, or poor response to dilatation, or if respiratory symptoms develop in an otherwise stable patient of esophageal stenosis. Narrow Band Imaging detects superficial squamous cell carcinoma more frequently than white-light imaging, and has significantly higher sensitivity and accuracy compared with white-light. Objective – To determinate the clinical applicability of Narrow Band Imaging versus Lugol´s solution chromendoscopy for detection of early esophageal cancer in patients with caustic/corrosive agent stenosis. Methods – Thirty-eight patients, aged between 28-84 were enrolled and examined by both Narrow Band Imaging and Lugol´s solution chromendoscopy. A 4.9mm diameter endoscope was used facilitating examination of a stenotic area without dilation. Narrow Band Imaging was performed and any lesion detected was marked for later biopsy. Then, Lugol´s solution chromoendoscopy was performed and biopsies were taken at suspicious areas. Patients who had abnormal findings at the routine, Narrow Band Imaging or Lugol´s solution chromoscopy exam had their stenotic ring biopsied. Results – We detected nine suspicious lesions with Narrow Band Imaging and 14 with Lugol´s solution chromendoscopy. The sensitivity and specificity of the Narrow Band Imaging was 100% and 80.6%, and with Lugol´s chromoscopy 100% and 66.67%, respectively. Five (13%) suspicious lesions were detected both with Narrow Band Imaging and Lugol’s chromoscopy, two (40%) of these lesions were confirmed carcinoma on histopathological examination. Conclusion – Narrow Band Imaging is an applicable option to detect and evaluate cancer in patients with caustic/corrosive stenosis compared to the Lugol´s solution chromoscopy.
AB - Background – The diagnosis of corrosion cancer should be suspected in patients with corrosive ingestion if after a latent period of negligible symptoms there is development of dysphagia, or poor response to dilatation, or if respiratory symptoms develop in an otherwise stable patient of esophageal stenosis. Narrow Band Imaging detects superficial squamous cell carcinoma more frequently than white-light imaging, and has significantly higher sensitivity and accuracy compared with white-light. Objective – To determinate the clinical applicability of Narrow Band Imaging versus Lugol´s solution chromendoscopy for detection of early esophageal cancer in patients with caustic/corrosive agent stenosis. Methods – Thirty-eight patients, aged between 28-84 were enrolled and examined by both Narrow Band Imaging and Lugol´s solution chromendoscopy. A 4.9mm diameter endoscope was used facilitating examination of a stenotic area without dilation. Narrow Band Imaging was performed and any lesion detected was marked for later biopsy. Then, Lugol´s solution chromoendoscopy was performed and biopsies were taken at suspicious areas. Patients who had abnormal findings at the routine, Narrow Band Imaging or Lugol´s solution chromoscopy exam had their stenotic ring biopsied. Results – We detected nine suspicious lesions with Narrow Band Imaging and 14 with Lugol´s solution chromendoscopy. The sensitivity and specificity of the Narrow Band Imaging was 100% and 80.6%, and with Lugol´s chromoscopy 100% and 66.67%, respectively. Five (13%) suspicious lesions were detected both with Narrow Band Imaging and Lugol’s chromoscopy, two (40%) of these lesions were confirmed carcinoma on histopathological examination. Conclusion – Narrow Band Imaging is an applicable option to detect and evaluate cancer in patients with caustic/corrosive stenosis compared to the Lugol´s solution chromoscopy.
KW - Adverse effects
KW - Caustics
KW - Esophageal neoplasms
KW - Iodides
KW - Squamous cell carcinoma
KW - Therapeutic use
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U2 - 10.1590/s0004-2803.201700000-19
DO - 10.1590/s0004-2803.201700000-19
M3 - Article
C2 - 28492712
AN - SCOPUS:85028652178
SN - 0004-2803
VL - 54
SP - 250
EP - 254
JO - Arquivos de Gastroenterologia
JF - Arquivos de Gastroenterologia
IS - 3
ER -