Esophageal dysplasias are detected by endoscopy with Lugol in patients at risk for squamous cell carcinoma in southern Brazil

Diagnosis of squamous cell carcinoma of the esophagus is usually late. Stai ning of the mucosa with Lugol's solution during endoscopy has been suggeste d to identify early cancer/dysplasia and may improve prognosis. Lugol was t ested during endoscopy in 96 asymptomatic subjects at risk for this tumor, who were found to have atypias after exfoliative cytology in southern Brazi l. Biopsies were obtained in Lugol's 'stained' and 'unstained' areas in the esophageal mucosa and the histologic results were compared. 'Unstained' ar eas were present in 64 (66.7%) instances: 44 'unstained' areas over mucosa with normal appearance revealed se, en dysplasias (four high and three low grade), whereas 20 'unstained' areas with visible lesions contained only on e dysplasia (low grade). 'Stained' areas in 96 (100%) subjects showed two a dditional dysplasias (one high and one low grade). In this study, Lugol 'un stained' areas were of great value for detection of dysplasias (sensitivity = 80%; specificity = 63%; p = 0.01, Fisher's exact test; CI = 95%; odds ra tio = 6.7).