title: Diagnostic accuracy of lugol chromoendoscopy in the oesophagus in patients with head and neck cancer.
abstract: OBJECTIVE
  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 > or = 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 + or - 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).
  
  
  CONCLUSIONS
  lugol staining of the oesophagus during endoscopy seems to be a feasible, safe and justified procedure in high-risk populationas it enhances the detection of premalignant lesions.
authors: Rita
authors: R
authors: Carvalho
authors: Miguel
authors: M
authors: Areia
authors: Daniel
authors: D
authors: Brito
authors: Sandra
authors: S
authors: Saraiva
authors: Susana
authors: S
authors: Alves
authors: Ana Teresa
authors: AT
authors: Cadime
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D004396:Coloring Agents; D004938:Esophageal Neoplasms / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007454:Iodides; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D004396:Coloring Agents; D007454:Iodides; C010389:Lugol's solution