• 1/27/2005
  • CL Hashimoto et al.
  • Am J Gastroenterol, February 1, 2005; 100(2): 275-82

Objective:
Patients with primary head and neck cancer show a predisposition to develop esophageal cancer. The aim of this study was to investigate in these patients: the prevalence of esophageal cancer comparing the value of chromoendoscopy using Lugol’s solution examination to standard endoscopy, in the early diagnosis of esophageal cancer.

Methods:
Prospective observational study at a state general university hospital in Sao Paulo, Brazil. 326 consecutive adult patients with primary head and neck cancer were evaluated. A standard endoscopy was performed, followed by a 2% lugol’s dye spray chromoendoscopy and histopathologic study. The prevalence of esophageal cancer was defined. The results of the two endoscopic methods were compared.

Results:
Twenty-four patients with esophageal cancer and high-grade intraepithelial neoplasia were detected and had a prevalence of 7.36%. Chromoendoscopy and standard endoscopy were equivalent to the diagnosis of advanced and invasive esophageal cancer. However, standard endoscopy diagnosed 55% of high-grade intraepithelial neoplasia, in comparison to chromoendoscopy that detected 100%.

Conclusions:
Patients with primary head and neck cancer should be considered as high risks for the presence of esophageal cancer. Lugol’s dye chromoendoscopy diagnosed high-grade intraepithelial neoplasia, which went unnoticed with standard endoscopy. It permits a more exact detection of lesion boundaries and facilitates a more precise targeting of biopsy fragments.

Authors:
CL Hashimoto, K Iriya, ER Baba, T Navarro-Rodriguez, MC Zerbini, JN Eisig, R Barbuti, D Chinzon, and JP Moraes-Filho

Authors’ affiliation:
Department of Gastroenterology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.