Lugol's dye spray chromoendoscopy establishes early diagnosis of esophageal cancer in patients with primary head and neck cancer.
OBJECTIVE
Patients with primary head and neck cancer show a predisposition to develop esophageal cancer. The aim of this study was to investigate in these patients: the prevalence of esophageal cancer comparing the value of chromoendoscopy using Lugol's solution examination to standard endoscopy, in the early diagnosis of esophageal cancer.


METHODS
Prospective observational study at a state general university hospital in Sao Paulo, Brazil. 326 consecutive adult patients with primary head and neck cancer were evaluated. A standard endoscopy was performed, followed by a 2% Lugol's dye spray chromoendoscopy and histopathologic study. The prevalence of esophageal cancer was defined. The results of the two endoscopic methods were compared.


RESULTS
Twenty-four patients with esophageal cancer and high-grade intraepithelial neoplasia were detected and had a prevalence of 7.36%. Chromoendoscopy and standard endoscopy were equivalent to the diagnosis of advanced and invasive esophageal cancer. However, standard endoscopy diagnosed 55% of high-grade intraepithelial neoplasia, in comparison to chromoendoscopy that detected 100%.


CONCLUSIONS
Patients with primary head and neck cancer should be considered as high risks for the presence of esophageal cancer. Lugol's dye chromoendoscopy diagnosed high-grade intraepithelial neoplasia, which went unnoticed with standard endoscopy. It permits a more exact detection of lesion boundaries and facilitates a more precise targeting of biopsy fragments.
Hashimoto
Claudio L
CL
Department of Gastroenterology, Faculty of Medicine, University of Sao Paulo, Rua Sousa Ramos 144, apto. 151, Sao Paulo 04120-081, Brazil.
Iriya
Kiyoshi
K
Baba
Elisa R
ER
Navarro-Rodriguez
Tomas
T
Zerbini
Maria C
MC
Eisig
Jaime N
JN
Barbuti
Ricardo
R
Chinzon
Decio
D
Moraes-Filho
Joaquim Prado P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D004396:Coloring Agents; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007454:Iodides; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010039:Otorhinolaryngologic Neoplasms; D013194:Staining and Labeling
D004396:Coloring Agents; D007454:Iodides; C010389:Lugol's solution