title: Lugol's dye spray chromoendoscopy establishes early diagnosis of esophageal cancer in patients with primary head and neck cancer.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, University of Sao Paulo, Rua Sousa Ramos 144, apto. 151, Sao Paulo 04120-081, Brazil.
authors.forename: Claudio L
authors.initials: CL
authors.lastname: Hashimoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Iriya
authors.forename: Elisa R
authors.initials: ER
authors.lastname: Baba
authors.forename: Tomas
authors.initials: T
authors.lastname: Navarro-Rodriguez
authors.forename: Maria C
authors.initials: MC
authors.lastname: Zerbini
authors.forename: Jaime N
authors.initials: JN
authors.lastname: Eisig
authors.forename: Ricardo
authors.initials: R
authors.lastname: Barbuti
authors.forename: Decio
authors.initials: D
authors.lastname: Chinzon
authors.forename: Joaquim Prado P
authors.initials: JP
authors.lastname: Moraes-Filho
mesh_terms: 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
chemical_list: D004396:Coloring Agents; D007454:Iodides; C010389:Lugol's solution