Early detection of esophageal carcinoma in alcoholics by endoscopy with iodine staining

Heavy alcohol consumption and cigarette smoking are important risk factors for esophageal carcinoma. Normal squamous cell epithelium is stained unifor mly with iodine solution in relation to the proportion of glycogen in the t issue. Carcinoma and dysplasia containing no glycogen remain distinctly uns tained. Patients: Hitherto, 85 alcoholics (68 men, 17 women; median 52 year s old; 78 smoker) were consecutively screened by endoscopy combined with ch romoendoscopy for esophageal carcinoma. 20 mi of 3% iodine solution was spr ayed onto the esophageus using a spray catheter. Targeted biopsies were tak en from lesions with a diameter of at least 5 mm. Results: After convention al endoscopy unexpected iodine undyed lesions were observed in 12 of 85 pat ients. The histopathological diagnoses were: one moderately differentiated squamous cell carcinoma, two leukoplacias, and nine inflammations. In the p atient with esophageal carcinoma, the tumour lesion was missed by endoscopy alone. He was treated with radiation alone due to bad performance status a nd liver cirrhosis. Conclusion: This study support the use of iodine staini ng in patients at risk, who undergo endoscopy.