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
| Autor: | Vivek Kumbhari, Caterina Maria Pia Simoni Pennachi, Diogo Turiani Hourneaux de Moura, Eduardo Guimarães Hourneaux de Moura, Renato Bastos Pimenta Amorim, Hugo Guedes |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Esophageal Neoplasms Endoscope Caustics Lugol's iodine Constriction Pathologic Gastroenterology Chromoendoscopy Narrow Band Imaging chemistry.chemical_compound 0302 clinical medicine Squamous cell carcinoma Carcinoma de células escamosas Iodetos Coloring Agents Aged 80 and over Cross-Over Studies Cáusticos medicine.diagnostic_test Middle Aged Esophageal cancer Dysphagia efeitos adversos 030220 oncology & carcinogenesis Esophageal neoplasms uso terapêutico Female 030211 gastroenterology & hepatology Esophagoscopy Radiology medicine.symptom Adult medicine.medical_specialty Sensitivity and Specificity 03 medical and health sciences Internal medicine Biopsy medicine Carcinoma Humans lcsh:RC799-869 Aged business.industry Neoplasias esofágicas Iodides medicine.disease Stenosis Cross-Sectional Studies chemistry therapeutic use adverse effects lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Arquivos de Gastroenterologia v.54 n.3 2017 Arquivos de gastroenterologia Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia instacron:IBEPEGE Arquivos de Gastroenterologia, Volume: 54, Issue: 3, Pages: 250-254, Published: 08 MAY 2017 Arquivos de Gastroenterologia, Vol 54, Iss 3, Pp 250-254 (2017) |
| Popis: | 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. RESUMO CONTEXTO A suspeita do câncer de esôfago na lesão cáustica ocorre quando os pacientes com estenoses previamente estáveis, após um período latente sem sintomas, apresentam disfagia, baixa resposta as dilatações ou sintomas respiratórios. A cromoscopia com luz de banda estreita detecta o câncer superficial de esôfago mais frequentemente que a luz branca, com alta sensibilidade e acurácia. OBJETIVO Determinar a aplicabilidade clínica da luz de banda estreita versus a cromoscopia vital com Lugol na detecção do câncer precoce de esôfago em pacientes com lesões cáusticas. MÉTODOS Um total de 38 pacientes, entre 28 e 84 anos, foram alocados seguidamente e submetidos à cromoscopia com luz de banda estreita e com Lugol. Um gastroscópio de 4,9 mm de diâmetro foi usado para facilitar o exame da área estenosada, sem necessidade de dilatação. A cromoscopia com luz de banda estreita era realizada primeiro e as áreas suspeitas anotadas. Depois, a cromoscopia com Lugol era realizada e as áreas suspeitas biopsiadas. RESULTADOS Detectamos nove lesões suspeitas com a luz de banda estreita e 14 com o Lugol. A sensibilidade e especificidade da cromoscopia com luz de banda estreita foi de 100% e 80,6%, e a do Lugol foi de 100% e 66,67% respectivamente. Cinco (13%) lesões suspeitas foram detectadas coincidentemente pelos dois métodos, sendo duas (40%) com diagnóstico anatomopatológico de câncer de esôfago. CONCLUSÃO A cromoscopia com luz de banda estreita é opção concreta para o diagnóstico de câncer em pacientes com estenoses esofágicas por corrosões cáusticas, comparado a cromoscopia com Lugol. |
| Databáze: | OpenAIRE |
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