Gastrointestinal Endoscopy Unit, São Paulo University Medical School, 05403-900 São Paulo, SP, Brazil.
J Oncol. 2013;2013:736756. doi: 10.1155/2013/736756. Epub 2013 Jul 9.
Chromoendoscopy with Lugol's staining remains the gold standard technique for detecting superficial SCC. An alternative technique, such as narrow-band imaging (NBI), for "optical staining" would be desirable, since NBI is a simpler technique and has no known complications. In this study, we compare NBI without magnification and chromoendoscopy with Lugol's staining for detecting high-grade dysplasia and intramucosal esophageal squamous cell carcinoma (SCC) in patients with achalasia. This was a prospective observational study of 43 patients with achalasia referred to the Gastrointestinal Endoscopy Unit of the Hospital of Clinics, São Paulo, University Medical School, Brazil, from October 2006 to February 2007. Conventional examinations with white light, NBI, and Lugol staining were consecutively performed, and the suspected lesions were mapped, recorded, and sent for biopsy. The results of the three methods were compared regarding sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood value, and negative likelihood value. Of the 43 patients, one was diagnosed with esophageal squamous cell carcinoma, and it was detected by all of the methods. NBI technology without magnification has high sensitivity and negative predictive value for detecting superficial esophageal squamous cell carcinoma, and it has comparable results with those obtained with Lugol's staining.
碘染色 chromoendoscopy 仍然是检测浅表 SCC 的金标准技术。另一种技术，如窄带成像（NBI）的“光学染色”，将是理想的，因为 NBI 是一种更简单的技术，并且没有已知的并发症。在这项研究中，我们比较了无放大的 NBI 和 Lugol 染色在检测贲门失弛缓症患者的高级别上皮内瘤变和黏膜内食管鳞状细胞癌（SCC）方面的效果。这是一项前瞻性观察研究，共纳入了 43 例来自巴西圣保罗大学临床医院胃肠道内镜科的贲门失弛缓症患者，研究时间为 2006 年 10 月至 2007 年 2 月。依次进行了白光、NBI 和 Lugol 染色的常规检查，并对可疑病变进行了标记、记录和活检。比较了三种方法的敏感性、特异性、准确性、阳性预测值、阴性预测值、阳性似然比和阴性似然比。在 43 例患者中，1 例被诊断为食管鳞状细胞癌，所有方法均检测到。无放大的 NBI 技术对检测浅表食管鳞状细胞癌具有较高的敏感性和阴性预测值，其结果与 Lugol 染色相当。
