Esophageal cancer is highly malignant and frequently has synchronous malignant foci or superficially spreading lesions from the main mass at the time of diagnosis. Therapeutic plan is usually determined based on the depth of invasion and the existence of malignant foci apart from the main mass. A prospective study was performed to evaluate the clinical usefulness of chromoscopy using Lugol's solution for detecting other malignant foci in patients with esophageal cancer. Between Jan. 1996 and Oct. 1996, chromoscopy was performed in 32 patients with esophageal cancer without stenosis or fistula. After conventional endoscopic examination, 20 ml of Lugol's solution were sprayed from the gastro-esophageal junction to the lower margin of upper esophageal sphincter. After 30-60 seconds, the esophageal mucosa was washed gently with 30 ml of tap water. Tissues were taken at all lesions unstained for histological diagnosis. All patients were male. The median age was 63 years with a range from 45 to 81 years. Fifty-five unstained lesions other than main tumor were detected in 21 patients (65.6%). Of 55 unstained lesions, 18 (32.7%) were squamous cell carcinoma (SCC) and 15 (27.3%) were dysplasia. Eleven (34.4%) patients turned out to have other malignant foci only after spraying Lugol's solution. All unstained lesions over 14 mm in diameter were carcinoma. Average distance between main tumor and unstained lesions was 5.7 cm (range, 1-22 cm). Most unstained lesions with carcinoma existed within 10 cm from the main tumor. Pathology 2-5 mm 6-10 mm 11-15 mm 16-50 mm Total (%) SCC 1 2 3 12 18 (32.7) Dysplasia 4 9 2 0 15 (27.3) Others 13 8 1 0 22 (40.0) No. (%) 18 (32.7) 19 (34.5) 6 (10.9) 12 (21.8) 55 (100) In conclusion, chromoscopy might be useful to detect the other malignant foci in patients with esophageal cancer.
|State||Published - 1997|