Cromoscopia vital com lugol versus cromoscopia óptica na detecção de câncer de esôfago em pacientes com estenoses cáusticas esofagianas

Translated title of the contribution: 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

Caterina Maria Pia Simoni Pennachi, Diogo Turiani Hourneaux de Moura, Renato Bastos Pimenta Amorim, Hugo Gonçalo Guedes, Vivek Kumbhari, Eduardo Guimarães Hourneaux de Moura

Research output: Contribution to journalArticle

Abstract

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.

Original languagePortuguese
Pages (from-to)250-254
Number of pages5
JournalArquivos de Gastroenterologia
Volume54
Issue number3
DOIs
StatePublished - Jul 1 2017

Fingerprint

Narrow Band Imaging
Caustics
Esophageal Neoplasms
Endoscopy
Pathologic Constriction
Eating
Dilatation
Biopsy
Lugol's solution
Light
Esophageal Stenosis
Corrosion
Endoscopes
Deglutition Disorders
Squamous Cell Carcinoma
Neoplasms
Carcinoma

Keywords

  • Adverse effects
  • Caustics
  • Esophageal neoplasms
  • Iodides
  • Squamous cell carcinoma
  • Therapeutic use

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cromoscopia vital com lugol versus cromoscopia óptica na detecção de câncer de esôfago em pacientes com estenoses cáusticas esofagianas. / Pennachi, Caterina Maria Pia Simoni; de Moura, Diogo Turiani Hourneaux; Amorim, Renato Bastos Pimenta; Guedes, Hugo Gonçalo; Kumbhari, Vivek; de Moura, Eduardo Guimarães Hourneaux.

In: Arquivos de Gastroenterologia, Vol. 54, No. 3, 01.07.2017, p. 250-254.

Research output: Contribution to journalArticle

Pennachi, Caterina Maria Pia Simoni ; de Moura, Diogo Turiani Hourneaux ; Amorim, Renato Bastos Pimenta ; Guedes, Hugo Gonçalo ; Kumbhari, Vivek ; de Moura, Eduardo Guimarães Hourneaux. / Cromoscopia vital com lugol versus cromoscopia óptica na detecção de câncer de esôfago em pacientes com estenoses cáusticas esofagianas. In: Arquivos de Gastroenterologia. 2017 ; Vol. 54, No. 3. pp. 250-254.
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abstract = "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.",
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