Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
J Clin Gastroenterol. 2010 Feb;44(2):e27-33. doi: 10.1097/MCG.0b013e3181b31325.
The relationship between esophageal squamous cell carcinoma (ESCC) and Lugol-voiding lesions (LVLs) in patients with head and neck squamous cell carcinoma (HNSCC) is unclear.
To investigate the characteristics of ESCC and the relationship between ESCC and LVLs in patients with HNSCC.
Between 2003 and 2006, 157 patients with primary HNSCC underwent Lugol chromoendoscopy at the Hiroshima University Hospital, Hiroshima, Japan. Of the patients, 135 were followed up for more than 6 months. We retrospectively analyzed the incidence of synchronous and metachronous ESCC and cumulative proportions of patients without metachronous ESCC with or without multiple LVLs.
Synchronous and metachronous ESCC were detected in 17 of 157 (10.8%) and 9 of 135 (6.7%) patients, respectively. The incidence of synchronous and metachronous ESCC was significantly higher in patients with LVLs compared with the incidence in those without LVLs [13 of 32 (40.6%) vs. 4 of 125 (3.2%), P<0.0001 and 8 of 19 (42.1%) vs. 1 of 116 (0.9%), P<0.0001, respectively]. Cumulative proportions of patients without metachronous ESCC were significantly lower in patients with multiple LVLs compared with that in those without multiple LVLs (P<0.0001).
Patients who had HNSCC, especially those with multiple LVLs in the esophagus, should be followed with close endoscopic observation with Lugol chromoendoscopy.
头颈部鳞状细胞癌(HNSCC)患者的食管鳞状细胞癌(ESCC)与卢戈氏碘液排空病变(LVLs)之间的关系尚不清楚。
探讨 HNSCC 患者 ESCC 的特征及 ESCC 与 LVLs 的关系。
2003 年至 2006 年,日本广岛大学医院对 157 例原发性 HNSCC 患者进行了卢戈氏碘液染色内镜检查,其中 135 例患者随访时间超过 6 个月。我们回顾性分析了同期和异时性 ESCC 的发生率以及有无多个 LVLs 的患者中无异时性 ESCC 的累积比例。
157 例患者中,17 例(10.8%)为同期 ESCC,9 例(6.7%)为异时性 ESCC。有 LVLs 的患者中,同期和异时性 ESCC 的发生率明显高于无 LVLs 的患者[13/32(40.6%)比 4/125(3.2%),P<0.0001;8/19(42.1%)比 1/116(0.9%),P<0.0001]。有多个 LVLs 的患者中,无异时性 ESCC 的累积比例明显低于无多个 LVLs 的患者(P<0.0001)。
患有 HNSCC 的患者,尤其是食管内有多个 LVLs 的患者,应密切进行内镜观察和卢戈氏碘液染色检查。