PMID- 19444514
OWN - NLM
STAT- MEDLINE
DCOM- 20120416
LR  - 20211020
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 23
IP  - 12
DP  - 2009 Dec
TI  - Lugol chromoendoscopy combined with brush cytology in patients at risk for 
      esophageal squamous cell carcinoma.
PG  - 2748-54
LID - 10.1007/s00464-009-0489-0 [doi]
AB  - BACKGROUND AND STUDY AIMS: Patients with achalasia or malignancies of the head 
      and neck are at increased risk for esophageal squamous cell carcinoma. The 
      discussion of a screening and surveillance program is controversial. The aim of 
      the present study was to determine the diagnostic potential of Lugol 
      chromoendoscopy combined with brush cytology to diagnose esophageal squamous cell 
      carcinoma and high-grade dysplasia. Secondly, the benefit of additional 
      biomarkers was investigated. PATIENTS AND METHODS: A total of 61 patients (21 
      patients with achalasia and 40 patients with malignancies of the head and neck) 
      were included. Chromoendoscopy with 1.2% Lugol iodine solution with targeted 
      biopsies and brush cytology processed by digital image cytometry (DICM) and 
      fluorescence in situ hybridization (FISH) from unstained lesions (USLs) and 
      stained mucosa were performed. RESULTS: Six of the 61 patients had USLs >/=2 cm. 
      Four patients had high-grade dysplasia (HGD) or carcinoma in situ (CIS). One 
      patient with HGD and one patient with CIS were detected only after Lugol 
      chromoendoscopy. The sensitivity and specificity for detected HGD or CIS in USLs 
      >/=2 cm were 100% and 96.5%. No dysplasia was found in USLs <2 cm. DNA ploidy by 
      DNA cytometry and p53 loss of heterozygosity (LOH) by fluorescence in situ 
      hybridization showed no additional impact on diagnostic accuracy. CONCLUSIONS: 
      Lugol chromoendoscopy enhances the detection rate of high-risk lesions with 
      dysplasia or carcinoma in situ in large unstained lesions. Biomarkers such as 
      aneuploidy and p53 LOH from brush cytology were not of additional benefit in this 
      setting.
FAU - Boller, D
AU  - Boller D
AD  - Division of Gastroenterology and Hepatology, Department of Medicine I, Cantonal 
      Hospital, St. Gallen 9007, Switzerland. d.boller@bluewin.ch
FAU - Spieler, P
AU  - Spieler P
FAU - Schoenegg, R
AU  - Schoenegg R
FAU - Neuweiler, J
AU  - Neuweiler J
FAU - Kradolfer, D
AU  - Kradolfer D
FAU - Studer, R
AU  - Studer R
FAU - Grossenbacher, R
AU  - Grossenbacher R
FAU - Zuercher, U
AU  - Zuercher U
FAU - Meyenberger, C
AU  - Meyenberger C
FAU - Borovicka, J
AU  - Borovicka J
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20090515
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Coloring Agents)
RN  - 0 (Iodides)
RN  - 9007-49-2 (DNA)
RN  - T66M6Y3KSA (Lugol's solution)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Carcinoma, Squamous Cell/genetics/*pathology
MH  - *Coloring Agents
MH  - Cytodiagnosis/methods
MH  - DNA/genetics
MH  - Early Detection of Cancer
MH  - Esophageal Achalasia/genetics/*pathology
MH  - Esophageal Neoplasms/genetics/*pathology
MH  - Esophagoscopy/*methods
MH  - Female
MH  - Genes, p53/genetics
MH  - Humans
MH  - In Situ Hybridization, Fluorescence/methods
MH  - *Iodides
MH  - Loss of Heterozygosity
MH  - Male
MH  - Middle Aged
MH  - Ploidies
MH  - Precancerous Conditions/genetics/pathology
MH  - Risk Factors
EDAT- 2009/05/16 09:00
MHDA- 2012/04/17 06:00
CRDT- 2009/05/16 09:00
PHST- 2008/11/18 00:00 [received]
PHST- 2009/03/25 00:00 [accepted]
PHST- 2009/02/24 00:00 [revised]
PHST- 2009/05/16 09:00 [entrez]
PHST- 2009/05/16 09:00 [pubmed]
PHST- 2012/04/17 06:00 [medline]
AID - 10.1007/s00464-009-0489-0 [doi]
PST - ppublish
SO  - Surg Endosc. 2009 Dec;23(12):2748-54. doi: 10.1007/s00464-009-0489-0. Epub 2009 
      May 15.