Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial
Background and Aim Lugol chromoendoscopy is the standard technique to detect an esophageal squamous cell carcinoma (ESCC). However, a high concentration of Lugol's solution can induce mucosal injury and adverse events. We aimed to investigate the optimal concentration of Lugol's solution t...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2023-06, Vol.38 (6), p.962-969 |
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| creator | Qu, Jun‐yan Li, Yan Liu, Guan‐qun Li, Zhen Zhong, Ning Zhang, Ming‐ming Li, Yue‐yue Yu, Tao Lu, Xue‐feng Li, Li‐xiang Liu, Han Qi, Qing‐qing Li, Yan‐qing Zuo, Xiu‐li |
| description | Background and Aim
Lugol chromoendoscopy is the standard technique to detect an esophageal squamous cell carcinoma (ESCC). However, a high concentration of Lugol's solution can induce mucosal injury and adverse events. We aimed to investigate the optimal concentration of Lugol's solution to reduce mucosal injury and adverse events without degrading image quality.
Methods
This was a two‐phase double‐blind randomized controlled trial. In phase I, 200 eligible patients underwent esophagogastroduodenoscopy and then were randomly (1:1:1:1:1) sprayed with 1.2%, 1.0%, 0.8%, 0.6%, or 0.4% Lugol's solution. Image quality, gastric mucosal injury, adverse events, and operation satisfaction were compared to investigate the minimal effective concentration. In phase II, 42 cases of endoscopic mucosectomy for early ESCC were included. The patients were randomly assigned (1:1) to the minimal effective (0.6%) or conventional (1.2%) concentration of Lugol's solution for further comparison of the effectiveness.
Results
In phase I, the gastric mucosal injury was significantly reduced in 0.6% group (P |
| doi_str_mv | 10.1111/jgh.16190 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2806072207</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2806072207</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3530-1ce6401e3dc4b4094f7c9a459d23d9c48d805481ebed7d54676b7afcc86e11203</originalsourceid><addsrcrecordid>eNp1kU1LAzEQhoMotlYP_gEJeFAPrckmu9l4K8VPCr3oeUmT2bolu2mTXaT-etNWPQjmMmF4eJiZF6FzSkY0vtvl4n1EMyrJAepTzsmQCp4doj7JaTqUjMoeOglhSQjhRKTHqMcEkVxy1kfr2aqtamWxdo2GpvWqrVyDXYmn3cLZq4CDs92uVzqPDbSg26pZYFDebjAEt3pXC9gKlNdV42p1h8fYq8a4uvoEsxW33lkbv62vlD1FR6WyAc6-6wC9Pdy_Tp6G09nj82Q8HWqWsriChowTCsxoPudx3FJoqXgqTcKM1Dw3OUl5TmEORpiUZyKbC1VqnWdAaULYAF3vvSvv1h2EtqiroMFa1YDrQpHkJCMiSYiI6OUfdOk638TpIpWkkkm5E97sKe1dCB7KYuXj6fymoKTY5lDEHIpdDpG9-DZ28xrML_lz-Ajc7oGPysLmf1Px8vi0V34BkLaSVg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2825939920</pqid></control><display><type>article</type><title>Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Qu, Jun‐yan ; Li, Yan ; Liu, Guan‐qun ; Li, Zhen ; Zhong, Ning ; Zhang, Ming‐ming ; Li, Yue‐yue ; Yu, Tao ; Lu, Xue‐feng ; Li, Li‐xiang ; Liu, Han ; Qi, Qing‐qing ; Li, Yan‐qing ; Zuo, Xiu‐li</creator><creatorcontrib>Qu, Jun‐yan ; Li, Yan ; Liu, Guan‐qun ; Li, Zhen ; Zhong, Ning ; Zhang, Ming‐ming ; Li, Yue‐yue ; Yu, Tao ; Lu, Xue‐feng ; Li, Li‐xiang ; Liu, Han ; Qi, Qing‐qing ; Li, Yan‐qing ; Zuo, Xiu‐li</creatorcontrib><description>Background and Aim
Lugol chromoendoscopy is the standard technique to detect an esophageal squamous cell carcinoma (ESCC). However, a high concentration of Lugol's solution can induce mucosal injury and adverse events. We aimed to investigate the optimal concentration of Lugol's solution to reduce mucosal injury and adverse events without degrading image quality.
Methods
This was a two‐phase double‐blind randomized controlled trial. In phase I, 200 eligible patients underwent esophagogastroduodenoscopy and then were randomly (1:1:1:1:1) sprayed with 1.2%, 1.0%, 0.8%, 0.6%, or 0.4% Lugol's solution. Image quality, gastric mucosal injury, adverse events, and operation satisfaction were compared to investigate the minimal effective concentration. In phase II, 42 cases of endoscopic mucosectomy for early ESCC were included. The patients were randomly assigned (1:1) to the minimal effective (0.6%) or conventional (1.2%) concentration of Lugol's solution for further comparison of the effectiveness.
Results
In phase I, the gastric mucosal injury was significantly reduced in 0.6% group (P < 0.05). Furthermore, there was no statistical significance in image quality between 0.6% and higher concentrations of Lugol's solution (P > 0.05, respectively). It also showed that the operation satisfaction decreased in 1.2% group compared with the lower concentration groups (P < 0.05). In phase II, the complete resection rate was 100% in both groups, while 0.6% Lugol's solution showed higher operation satisfaction (W = 554.500, P = 0.005).
Conclusions
The study indicates that 0.6% might be the optimal concentration of Lugol's solution for early detection and delineation of ESCC, considering minimal mucosal injury and satisfied image. The registry of clinical trials: ClinicalTrials.gov (NCT03180944).</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.16190</identifier><identifier>PMID: 37094943</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Adverse events ; Clinical trials ; Coloring Agents ; Esophageal cancer ; Esophageal carcinoma ; Esophageal Neoplasms - pathology ; Esophageal squamous cell cancer ; Esophageal Squamous Cell Carcinoma ; Esophagoscopy - methods ; Gastric mucosa ; Humans ; Image quality ; Lugol's solution ; Mucosa injury ; Squamous cell carcinoma</subject><ispartof>Journal of gastroenterology and hepatology, 2023-06, Vol.38 (6), p.962-969</ispartof><rights>2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-1ce6401e3dc4b4094f7c9a459d23d9c48d805481ebed7d54676b7afcc86e11203</citedby><cites>FETCH-LOGICAL-c3530-1ce6401e3dc4b4094f7c9a459d23d9c48d805481ebed7d54676b7afcc86e11203</cites><orcidid>0000-0003-0575-0399 ; 0000-0001-9556-8771 ; 0000-0001-7042-9695</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.16190$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.16190$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37094943$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qu, Jun‐yan</creatorcontrib><creatorcontrib>Li, Yan</creatorcontrib><creatorcontrib>Liu, Guan‐qun</creatorcontrib><creatorcontrib>Li, Zhen</creatorcontrib><creatorcontrib>Zhong, Ning</creatorcontrib><creatorcontrib>Zhang, Ming‐ming</creatorcontrib><creatorcontrib>Li, Yue‐yue</creatorcontrib><creatorcontrib>Yu, Tao</creatorcontrib><creatorcontrib>Lu, Xue‐feng</creatorcontrib><creatorcontrib>Li, Li‐xiang</creatorcontrib><creatorcontrib>Liu, Han</creatorcontrib><creatorcontrib>Qi, Qing‐qing</creatorcontrib><creatorcontrib>Li, Yan‐qing</creatorcontrib><creatorcontrib>Zuo, Xiu‐li</creatorcontrib><title>Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
Lugol chromoendoscopy is the standard technique to detect an esophageal squamous cell carcinoma (ESCC). However, a high concentration of Lugol's solution can induce mucosal injury and adverse events. We aimed to investigate the optimal concentration of Lugol's solution to reduce mucosal injury and adverse events without degrading image quality.
Methods
This was a two‐phase double‐blind randomized controlled trial. In phase I, 200 eligible patients underwent esophagogastroduodenoscopy and then were randomly (1:1:1:1:1) sprayed with 1.2%, 1.0%, 0.8%, 0.6%, or 0.4% Lugol's solution. Image quality, gastric mucosal injury, adverse events, and operation satisfaction were compared to investigate the minimal effective concentration. In phase II, 42 cases of endoscopic mucosectomy for early ESCC were included. The patients were randomly assigned (1:1) to the minimal effective (0.6%) or conventional (1.2%) concentration of Lugol's solution for further comparison of the effectiveness.
Results
In phase I, the gastric mucosal injury was significantly reduced in 0.6% group (P < 0.05). Furthermore, there was no statistical significance in image quality between 0.6% and higher concentrations of Lugol's solution (P > 0.05, respectively). It also showed that the operation satisfaction decreased in 1.2% group compared with the lower concentration groups (P < 0.05). In phase II, the complete resection rate was 100% in both groups, while 0.6% Lugol's solution showed higher operation satisfaction (W = 554.500, P = 0.005).
Conclusions
The study indicates that 0.6% might be the optimal concentration of Lugol's solution for early detection and delineation of ESCC, considering minimal mucosal injury and satisfied image. The registry of clinical trials: ClinicalTrials.gov (NCT03180944).</description><subject>Adverse events</subject><subject>Clinical trials</subject><subject>Coloring Agents</subject><subject>Esophageal cancer</subject><subject>Esophageal carcinoma</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal squamous cell cancer</subject><subject>Esophageal Squamous Cell Carcinoma</subject><subject>Esophagoscopy - methods</subject><subject>Gastric mucosa</subject><subject>Humans</subject><subject>Image quality</subject><subject>Lugol's solution</subject><subject>Mucosa injury</subject><subject>Squamous cell carcinoma</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1LAzEQhoMotlYP_gEJeFAPrckmu9l4K8VPCr3oeUmT2bolu2mTXaT-etNWPQjmMmF4eJiZF6FzSkY0vtvl4n1EMyrJAepTzsmQCp4doj7JaTqUjMoeOglhSQjhRKTHqMcEkVxy1kfr2aqtamWxdo2GpvWqrVyDXYmn3cLZq4CDs92uVzqPDbSg26pZYFDebjAEt3pXC9gKlNdV42p1h8fYq8a4uvoEsxW33lkbv62vlD1FR6WyAc6-6wC9Pdy_Tp6G09nj82Q8HWqWsriChowTCsxoPudx3FJoqXgqTcKM1Dw3OUl5TmEORpiUZyKbC1VqnWdAaULYAF3vvSvv1h2EtqiroMFa1YDrQpHkJCMiSYiI6OUfdOk638TpIpWkkkm5E97sKe1dCB7KYuXj6fymoKTY5lDEHIpdDpG9-DZ28xrML_lz-Ajc7oGPysLmf1Px8vi0V34BkLaSVg</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Qu, Jun‐yan</creator><creator>Li, Yan</creator><creator>Liu, Guan‐qun</creator><creator>Li, Zhen</creator><creator>Zhong, Ning</creator><creator>Zhang, Ming‐ming</creator><creator>Li, Yue‐yue</creator><creator>Yu, Tao</creator><creator>Lu, Xue‐feng</creator><creator>Li, Li‐xiang</creator><creator>Liu, Han</creator><creator>Qi, Qing‐qing</creator><creator>Li, Yan‐qing</creator><creator>Zuo, Xiu‐li</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0575-0399</orcidid><orcidid>https://orcid.org/0000-0001-9556-8771</orcidid><orcidid>https://orcid.org/0000-0001-7042-9695</orcidid></search><sort><creationdate>202306</creationdate><title>Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial</title><author>Qu, Jun‐yan ; Li, Yan ; Liu, Guan‐qun ; Li, Zhen ; Zhong, Ning ; Zhang, Ming‐ming ; Li, Yue‐yue ; Yu, Tao ; Lu, Xue‐feng ; Li, Li‐xiang ; Liu, Han ; Qi, Qing‐qing ; Li, Yan‐qing ; Zuo, Xiu‐li</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-1ce6401e3dc4b4094f7c9a459d23d9c48d805481ebed7d54676b7afcc86e11203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adverse events</topic><topic>Clinical trials</topic><topic>Coloring Agents</topic><topic>Esophageal cancer</topic><topic>Esophageal carcinoma</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal squamous cell cancer</topic><topic>Esophageal Squamous Cell Carcinoma</topic><topic>Esophagoscopy - methods</topic><topic>Gastric mucosa</topic><topic>Humans</topic><topic>Image quality</topic><topic>Lugol's solution</topic><topic>Mucosa injury</topic><topic>Squamous cell carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qu, Jun‐yan</creatorcontrib><creatorcontrib>Li, Yan</creatorcontrib><creatorcontrib>Liu, Guan‐qun</creatorcontrib><creatorcontrib>Li, Zhen</creatorcontrib><creatorcontrib>Zhong, Ning</creatorcontrib><creatorcontrib>Zhang, Ming‐ming</creatorcontrib><creatorcontrib>Li, Yue‐yue</creatorcontrib><creatorcontrib>Yu, Tao</creatorcontrib><creatorcontrib>Lu, Xue‐feng</creatorcontrib><creatorcontrib>Li, Li‐xiang</creatorcontrib><creatorcontrib>Liu, Han</creatorcontrib><creatorcontrib>Qi, Qing‐qing</creatorcontrib><creatorcontrib>Li, Yan‐qing</creatorcontrib><creatorcontrib>Zuo, Xiu‐li</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qu, Jun‐yan</au><au>Li, Yan</au><au>Liu, Guan‐qun</au><au>Li, Zhen</au><au>Zhong, Ning</au><au>Zhang, Ming‐ming</au><au>Li, Yue‐yue</au><au>Yu, Tao</au><au>Lu, Xue‐feng</au><au>Li, Li‐xiang</au><au>Liu, Han</au><au>Qi, Qing‐qing</au><au>Li, Yan‐qing</au><au>Zuo, Xiu‐li</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2023-06</date><risdate>2023</risdate><volume>38</volume><issue>6</issue><spage>962</spage><epage>969</epage><pages>962-969</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
Lugol chromoendoscopy is the standard technique to detect an esophageal squamous cell carcinoma (ESCC). However, a high concentration of Lugol's solution can induce mucosal injury and adverse events. We aimed to investigate the optimal concentration of Lugol's solution to reduce mucosal injury and adverse events without degrading image quality.
Methods
This was a two‐phase double‐blind randomized controlled trial. In phase I, 200 eligible patients underwent esophagogastroduodenoscopy and then were randomly (1:1:1:1:1) sprayed with 1.2%, 1.0%, 0.8%, 0.6%, or 0.4% Lugol's solution. Image quality, gastric mucosal injury, adverse events, and operation satisfaction were compared to investigate the minimal effective concentration. In phase II, 42 cases of endoscopic mucosectomy for early ESCC were included. The patients were randomly assigned (1:1) to the minimal effective (0.6%) or conventional (1.2%) concentration of Lugol's solution for further comparison of the effectiveness.
Results
In phase I, the gastric mucosal injury was significantly reduced in 0.6% group (P < 0.05). Furthermore, there was no statistical significance in image quality between 0.6% and higher concentrations of Lugol's solution (P > 0.05, respectively). It also showed that the operation satisfaction decreased in 1.2% group compared with the lower concentration groups (P < 0.05). In phase II, the complete resection rate was 100% in both groups, while 0.6% Lugol's solution showed higher operation satisfaction (W = 554.500, P = 0.005).
Conclusions
The study indicates that 0.6% might be the optimal concentration of Lugol's solution for early detection and delineation of ESCC, considering minimal mucosal injury and satisfied image. The registry of clinical trials: ClinicalTrials.gov (NCT03180944).</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37094943</pmid><doi>10.1111/jgh.16190</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0575-0399</orcidid><orcidid>https://orcid.org/0000-0001-9556-8771</orcidid><orcidid>https://orcid.org/0000-0001-7042-9695</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adverse events Clinical trials Coloring Agents Esophageal cancer Esophageal carcinoma Esophageal Neoplasms - pathology Esophageal squamous cell cancer Esophageal Squamous Cell Carcinoma Esophagoscopy - methods Gastric mucosa Humans Image quality Lugol's solution Mucosa injury Squamous cell carcinoma |
| title | Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial |
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