Carvalho Rita, Areia Miguel, Brito Daniel, Saraiva Sandra, Alves Susana, Cadime Ana Teresa
Rev Esp Enferm Dig. 2013 Feb;105(2):79-83. doi: 10.4321/s1130-01082013000200004.
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.
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.
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).
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.
头颈部鳞状细胞恶性肿瘤患者患食管鳞状细胞癌的风险较高。食管卢戈氏染色内镜检查是一种简单的技术，对癌前病变具有较高的诊断率。目的是分析其在高危患者食管发育异常和癌中的诊断准确性。
2008年4月至2012年1月进行的前瞻性研究，采用卢戈氏染色内镜检查并对可疑的卢戈氏不着色区（≥5mm）进行活检。纳入头颈部恶性肿瘤患者，但碘过敏、食管静脉曲张和标准内镜检查禁忌症患者除外。参考方法为组织病理学检查。
共纳入89例患者（平均年龄62.8±13.3岁，87%为男性）。原发肿瘤位于口咽37例（41.6%），口腔29例（32.6%），喉23例（25.8%）。40.4%的患者曾接受过治疗，87%的患者有酗酒或吸烟史。所有检查均在无麻醉且无并发症的情况下进行。观察到9个可疑的卢戈氏不着色区并进行了活检。组织病理学分析显示2例（2.2%）为高级别发育异常，其余为炎症或正常表现。检测高级别发育异常的敏感性和特异性分别为100%和92%（95%CI：87-97）。该检查的诊断准确性为92%（95%CI：86-98）。
内镜检查时食管卢戈氏染色在高危人群中似乎是一种可行、安全且合理的检查方法，因为它能提高癌前病变的检出率。
