CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS
ABSTRACT BACKGROUND: Esophageal cancer is the eighth most common cancer. The prognosis is bleak in patients with advanced stages. Patients with early disease have a better prognosis than those with advanced stage. There are several techniques for the screening of premalignant and superficial lesio...
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| Format: | Article |
| Language: | English |
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
2019-03-01
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| Series: | Arquivos de Gastroenterologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032019005001101&lng=en&tlng=en |
| _version_ | 1819031354799554560 |
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| author | Jean Félix PIÑERÚA-GONSÁLVEZ Rosanna del Carmen ZAMBRANO-INFANTINO Sylvia BENÍTEZ |
| author_facet | Jean Félix PIÑERÚA-GONSÁLVEZ Rosanna del Carmen ZAMBRANO-INFANTINO Sylvia BENÍTEZ |
| author_sort | Jean Félix PIÑERÚA-GONSÁLVEZ |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Esophageal cancer is the eighth most common cancer. The prognosis is bleak in patients with advanced stages. Patients with early disease have a better prognosis than those with advanced stage. There are several techniques for the screening of premalignant and superficial lesions including chromoendoscopy. OBJECTIVE: This article aimed to determine the effectiveness of chromoendoscopy with toluidine blue combined with Lugol’s solution for diagnosis of esophageal premalignant and superficial neoplastic lesions in high risk patients. METHODS: Routine white light upper endoscopy was performed. Toluidine blue was sprayed from the gastroesophageal junction to 20 cm of the dental arch. Then the uptake dye areas were characterized. Later Lugol’s solution was sprayed. Areas with less-intense staining were characterized. Biopsy of the toluidine blue capturing areas and areas with less-intense staining of Lugol’s solution were taken. In the cases where lesions were not evidenced after application of dyes, biopsies four quadrants of the esophageal mucosa were taken. The samples were evaluated by a digestive pathologist. RESULTS: Barrett’s esophagus was the most common premalignant lesion and the early neoplastic lesion was adenocarcinoma with a sensitivity of 100%, specificity 85.7%, positive predictive value 30%, negative predictive value 100%, positive likelihood ratio 7 negative likelihood ratio 0. CONCLUSION: Chromoendoscopy with toluidine blue combined with Lugol’s solution is a useful tool in the screening of esophageal premalignant lesions and superficial neoplasms. |
| first_indexed | 2024-12-21T06:44:43Z |
| format | Article |
| id | doaj.art-70f16ff9d5304506a3c4175613ae6d66 |
| institution | Directory Open Access Journal |
| issn | 1678-4219 |
| language | English |
| last_indexed | 2024-12-21T06:44:43Z |
| publishDate | 2019-03-01 |
| publisher | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
| record_format | Article |
| series | Arquivos de Gastroenterologia |
| spelling | doaj.art-70f16ff9d5304506a3c4175613ae6d662022-12-21T19:12:38ZengInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)Arquivos de Gastroenterologia1678-42192019-03-01010.1590/s0004-2803.201900000-01S0004-28032019005001101CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTSJean Félix PIÑERÚA-GONSÁLVEZRosanna del Carmen ZAMBRANO-INFANTINOSylvia BENÍTEZABSTRACT BACKGROUND: Esophageal cancer is the eighth most common cancer. The prognosis is bleak in patients with advanced stages. Patients with early disease have a better prognosis than those with advanced stage. There are several techniques for the screening of premalignant and superficial lesions including chromoendoscopy. OBJECTIVE: This article aimed to determine the effectiveness of chromoendoscopy with toluidine blue combined with Lugol’s solution for diagnosis of esophageal premalignant and superficial neoplastic lesions in high risk patients. METHODS: Routine white light upper endoscopy was performed. Toluidine blue was sprayed from the gastroesophageal junction to 20 cm of the dental arch. Then the uptake dye areas were characterized. Later Lugol’s solution was sprayed. Areas with less-intense staining were characterized. Biopsy of the toluidine blue capturing areas and areas with less-intense staining of Lugol’s solution were taken. In the cases where lesions were not evidenced after application of dyes, biopsies four quadrants of the esophageal mucosa were taken. The samples were evaluated by a digestive pathologist. RESULTS: Barrett’s esophagus was the most common premalignant lesion and the early neoplastic lesion was adenocarcinoma with a sensitivity of 100%, specificity 85.7%, positive predictive value 30%, negative predictive value 100%, positive likelihood ratio 7 negative likelihood ratio 0. CONCLUSION: Chromoendoscopy with toluidine blue combined with Lugol’s solution is a useful tool in the screening of esophageal premalignant lesions and superficial neoplasms.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032019005001101&lng=en&tlng=enEsophageal neoplasmsTolonium chlorideStaining and labelingEarly detection of cancer |
| spellingShingle | Jean Félix PIÑERÚA-GONSÁLVEZ Rosanna del Carmen ZAMBRANO-INFANTINO Sylvia BENÍTEZ CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS Arquivos de Gastroenterologia Esophageal neoplasms Tolonium chloride Staining and labeling Early detection of cancer |
| title | CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS |
| title_full | CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS |
| title_fullStr | CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS |
| title_full_unstemmed | CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS |
| title_short | CHROMOENDOSCOPY USING TOLUIDINE BLUE PLUS LUGOL’S SOLUTION FOR EARLY DIAGNOSIS OF ESOPHAGEAL PREMALIGNANT LESIONS AND SUPERFICIAL NEOPLASMS IN HIGH-RISK PATIENTS |
| title_sort | chromoendoscopy using toluidine blue plus lugol s solution for early diagnosis of esophageal premalignant lesions and superficial neoplasms in high risk patients |
| topic | Esophageal neoplasms Tolonium chloride Staining and labeling Early detection of cancer |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032019005001101&lng=en&tlng=en |
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