Diagnosis of superficial esophageal cancer and dysplasia using endoscopic screening with a 2% lugol dye solution in patients with head and neck cancer.
BACKGROUND
Head and neck cancer (HNC) has a high incidence in Brazil, with cancer of the oral cavity being one of the five most common cancers among Brazilians. Alcohol and tobacco consumption may contribute to synchronous or metachronous HNC and esophageal cancer. The early detection of superficial esophageal cancer and dysplasia in asymptomatic patients with HNC, after successfully treating the primary cancer, may provide an effective cure.


METHODS
A prospective study involving 60 patients with HNC was carried out at the State University of Campinas (UNICAMP) to screen for superficial esophageal cancer and dysplasia using endoscopy and a 2% lugol dye solution followed by biopsy of the suspicious areas.


RESULTS
Five patients (8.3%) had superficial esophageal cancer, which was diagnosed as intraepithelial carcinoma in three of them (5.0%). In four patients, the superficial esophageal cancer was synchronous, and in one it was metachronous to HNC. Five patients (8.3%) had dysplasias in the esophageal epithelium (three were classified as mild and two as moderate).


CONCLUSIONS
These results demonstrate the value of endoscopic screening of the esophagus using lugol dye in patients with HNC, particularly because superficial esophageal cancer is extremely difficult to detect by conventional methods in asymptomatic patients.
Tincani
A J
AJ
Head and Neck Service, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
Brandalise
N
N
Altemani
A
A
Scanavini
R C
RC
Valério
J B
JB
Lage
H T
HT
Molina
G
G
Martins
A S
AS
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary; D004396:Coloring Agents; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D006801:Humans; D007454:Iodides; D007455:Iodine; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014741:Video Recording
D004396:Coloring Agents; D007454:Iodides; D007455:Iodine; C010389:Lugol's solution