Fukuhara Tatsuma, Hiyama Toru, Tanaka Shinji, Oka Shiro, Yoshihara Masaharu, Arihiro Koji, Chayama Kazuaki
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
Digestion. 2010;82(1):60-5. doi: 10.1159/000284371. Epub 2010 Mar 5.
The presence of multiple Lugol-voiding lesions (LVLs) in the esophageal mucosa can indicate a high risk of esophageal squamous cell carcinoma (ESCC) as well as a diagnosis of ESCC and dysplasia. However, there have been no reports on the natural course of LVLs.
This study aimed to clarify the characteristics and natural course of LVLs.
Based on patients with ESCC who underwent endoscopic treatment, a retrospective study was conducted targeting 73 patients in whom the esophageal background mucosa was evaluated using Lugol staining and who were followed up for 12 months or more. LVLs were divided into groups A (none), B (several small), C (many small), and D (many irregular-shaped multiform).
The average follow-up period was 42.0 months. Groups A-D consisted of 13, 34, 21, and 5 patients, respectively. In group B, 3 of 34 (8.8%) patients advanced to group C. In group C, 2 of 21 (9.5%) patients advanced to group D. In total, 5 of all 73 (6.8%) patients advanced to a higher group.
These data suggest that a risk of ESCC may obviously increase in only some of the patients by evaluation of LVLs.
食管黏膜中存在多个不染碘病变（LVLs）可提示食管鳞状细胞癌（ESCC）的高风险以及ESCC和发育异常的诊断。然而，关于LVLs的自然病程尚无报道。
本研究旨在阐明LVLs的特征和自然病程。
基于接受内镜治疗的ESCC患者，对73例使用卢戈氏染色评估食管背景黏膜并随访12个月或更长时间的患者进行回顾性研究。LVLs分为A组（无）、B组（几个小病变）、C组（许多小病变）和D组（许多不规则形状的多样病变）。
平均随访期为42.0个月。A - D组分别由13、34、21和5例患者组成。B组中，34例患者中有3例（8.8%）进展为C组。C组中，21例患者中有2例（9.5%）进展为D组。总共73例患者中有5例（6.8%）进展到更高组。
这些数据表明，通过评估LVLs，仅部分患者发生ESCC的风险可能明显增加。
