Endoscopic findings corresponding to multiple Lugol‐voiding lesions in the esophageal background mucosa

• Published in: Journal of gastroenterology and hepatology 2019-02, Vol.34 (2), p.390-396
• Main Authors: Matsuno, Kenshi, Ishihara, Ryu, Nakagawa, Kentaro, Ohmori, Masayasu, Iwagami, Hiroyoshi, Inoue, Shuntaro, Iwatsubo, Taro, Nakahira, Hiroko, Matsuura, Noriko, Shichijyo, Satoki, Maekawa, Akira, Takashi, Kanesaka, Yamamoto, Sachiko, Takeuchi, Yoji, Higashino, Koji, Uedo, Noriya, Matsunaga, Takashi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; blue laser imaging; Coloring Agents; Endoscopy; Esophageal Mucosa - pathology; Esophageal Neoplasms - pathology; esophageal squamous cell carcinoma; Esophageal Squamous Cell Carcinoma - pathology; Esophagoscopy; Esophagus; Female; Head and neck; Humans; Iodides; Lasers; Lugol chromoendoscopy; Male; Microvasculature; Middle Aged; Mucosa; multiple Lugol‐voiding lesions; Narrow Band Imaging; Neoplasms, Second Primary - pathology; Pain; Pilot Projects; Predictive Value of Tests; Retrospective Studies; Squamous cell carcinoma
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.14439

Background and Aim Multiple Lugol‐voiding lesions (LVLs) on Lugol chromoendoscopy can predict the development of metachronous multiple cancers in the esophagus and the head and neck regions. However, Lugol chromoendoscopy sometimes causes adverse events such as chest pain and discomfort. We therefore investigated the endoscopic findings on narrow band imaging (NBI) or blue laser imaging (BLI) that correspond to the presence of multiple LVLs in patients with esophageal squamous cell carcinoma. Methods First, we investigated the NBI/BLI findings corresponding to individual small LVLs (one‐to‐one correspondence). Second, we investigated the association between the grade of multiple LVLs and the five endoscopic findings, including multiple foci of dilated vessels (MDV), multiple small brownish areas without microvascular irregularity, and a nonuniform color tone. Results One‐to‐one correspondence of endoscopic findings was analyzed in 106 small LVLs. The main findings matched with small LVLs were a focus of dilated vessels (44 lesions), a small brownish area (17 lesions), and a small brownish area with a focus of dilated vessels (19 lesions). The relationship between multiple LVLs and each finding assessed by NBI/BLI was assessed in 155 patients. Multivariate logistic regression indicated that the presence of MDV was the only finding independently associated with multiple LVLs (P