Torakochirurgia
Application of Lugol\'s solution in diagnostics of oesophageal diseases with high risk of malignancy

Background:
The prognosis in patients with squamous cell carcinoma of the oesophagus and oesophagogastric junction is poor and demands application of methods which enable early identification of high risk states of cancer development.

Aim:
Endoscopic examination followed by Lugol\'s solution staining is used in the diagnostics of early squamous cell carcinoma of the oesophagus. The study describes the use of this method for assessment of effectiveness in diseases of the oesophagus with a high risk of malignancy.

Material and methods:
The study was conducted with
98 patients. The method makes use of a reaction between glycogen, contained in oesophageal epithelium, and the iodine in Lugol\'s solution. Before applying Lugol\'s solution an endoscopic assessment was made. Subsequently the oesophagogastric border and staining of mucosa after application of Lugol\'s solution were evaluated. Biopsy was carried out from the stained and unstained places.

Results:
High sensitivity (83%) and specificity (63%) are characteristic of this method and the ratio of the stained and unstained places is statistically significant. Thanks to the proper evaluation of the oesophagogastric junction the method enables one to make a correct diagnosis of Barrett\'s oesophagus. Although early oesophageal cancer was not detected, in one case high grade dysplasia connected with 3rd degree oesophagitis was diagnosed.

Conclusions:
Early oesophageal cancer was not detected in the carried out examination. However, the endoscopic screening, combined with Lugol\'s dye staining, is a sensitive diagnostic method for detecting abnormalities of a high risk of cancer development.