Background: The presence of multiple Lugol-voiding lesions (LVLs) in the esophageal mucosa can indicate a high risk of esophageal squamous cell carcinoma (ESCC) as well as a diagnosis of ESCC and dysplasia. However, there have been no reports on the natural course of LVLs. Aim: This study aimed to clarify the characteristics and natural course of LVLs. Methods: Based on patients with ESCC who underwent endoscopic treatment, a retrospective study was conducted targeting 73 patients in whom the esophageal background mucosa was evaluated using Lugol staining and who were followed up for 12 months or more. LVLs were divided into groups A (none), B (several small), C (many small), and D (many irregular-shaped multiform). Results: The average follow-up period was 42.0 months. Groups A–D consisted of 13, 34, 21, and 5 patients, respectively. In group B, 3 of 34 (8.8%) patients advanced to group C. In group C, 2 of 21 (9.5%) patients advanced to group D. In total, 5 of all 73 (6.8%) patients advanced to a higher group. Conclusion: These data suggest that a risk of ESCC may obviously increase in only some of the patients by evaluation of LVLs.

Journal Section:
Original Paper
Keywords:
Lugol-voiding lesion, natural course, Esophageal squamous cell carcinoma, Carcinoma, digestive tract
1.
Parkin DM, Pisani P, Ferlay J: Estimates of the worldwide incidence of eighteen major cancers in 1985. Int J Cancer 1993;54:594–606.
[PubMed]
https://doi.org/10.1002%2Fijc.2910540413
2.
Roth JA, Putnam JB Jr: Surgery for cancer of the esophagus. Semin Oncol 1994;21:453–461.
[PubMed]
3.
Meyer V, Burtin P, Bour B, et al: Endoscopic detection of early esophageal cancer in a high-risk population: does Lugol staining improve videoendoscopy? Gastrointest Endosc 1997;45:480–484.
[PubMed]
https://doi.org/10.1016%2FS0016-5107%2897%2970177-9
4.
Hashimoto CL, Iriya K, Baba ER, et al: Lugol’s dye spray chromoendoscopy establishes early diagnosis of esophageal cancer in patients with primary head and neck cancer. Am J Gastroenterol 2005;100:275–282.
[PubMed]
https://doi.org/10.1111%2Fj.1572-0241.2005.30189.x
5.
Mori M, Adachi Y, Matsushima T, et al: Lugol staining pattern and histology of esophageal lesions. Am J Gastroenterol 1993;88:701–705.
[PubMed]
6.
Urabe Y, Hiyama T, Tanaka S, et al: Metachronous multiple esophageal squamous cell carcinomas and Lugol-voiding lesions after endoscopic mucosal resection. Endoscopy 2009;41:304–309.
[PubMed]
https://doi.org/10.1055%2Fs-0029-1214477
7.
Fukuhara T, Hiyama T, Tanaka S, et al: Characteristics of esophageal squamous cell carcinomas and Lugol-voiding lesions in patients with head and neck squamous cell carcinoma. J Clin Gastroenterol 2010;44: e27–e33.
[PubMed]
https://doi.org/10.1097%2FMCG.0b013e3181b31325
8.
Muto M, Hironaka S, Nakane M, et al: Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer. Gastrointest Endosc 2002;56:517–521.
[PubMed]
https://doi.org/10.1016%2FS0016-5107%2802%2970436-7
9.
Japanese Society for Esophageal Disease: Guidelines for Clinical and Pathological Studies on Carcinoma of the Esophagus, ed 10. Tokyo, Kanehara, 2007.
10.
Warren S, Gates O: Multiple primary malignant tumors. A survey of the literature and a statistical study. Am J Cancer 1932;16:1358–1414.
11.
Dubuc J, Legoux JL, Winnock M, et al: Endoscopic screening for esophageal squamous-cell carcinoma in high-risk patients: a prospective study conducted in 62 French endoscopy centers. Endoscopy 2006;38:690–695.
[PubMed]
https://doi.org/10.1055%2Fs-2006-925255
12.
Muto M, Takahashi M, Ohtsu A, et al: Risk of multiple squamous cell carcinomas both in the esophagus and the head and neck region. Carcinogenesis 2005;26:1008–1012.
[PubMed]
https://doi.org/10.1093%2Fcarcin%2Fbgi035
13.
Matsuda T, Marugame T, Kamo K, et al: Cancer incidence and incidence rates in Japan in 2003: based on data from 11 population-based cancer registries. Jpn J Clin Oncol 2008;38:641–648.
[PubMed]
https://doi.org/10.1093%2Fjjco%2Fhyn074
14.
Ministry of Health Labour and Welfare: The National Health and Nutrition Survey 2004, Japan [in Japanese]. Tokyo, Ministry of Health, Labour and Welfare, 2006.
15.
Muto M, Hitomi Y, Ohtsu A, et al: Association of aldehyde dehydrogenase 2 gene polymorphism with multiple oesophageal dysplasia in head and neck cancer patients. Gut 2000;47:256–261.
[PubMed]
https://doi.org/10.1136%2Fgut.47.2.256
© 2010 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2010
You do not currently have access to this content.