Intraoperative Chemodetection for Mucosal Lesions Among Patients With Head and Neck Cancer

Chien-An Ko ； Yu-Tsai Lin ； Chun-Hang Tseng ； Ming-Hsien Tsai ； Chao-Cheng Huang ； Chih-Yen Chien ； Hui-Ching Chuang

《International Journal of Head and Neck Science》 2卷3期 (2018/09) Pp. 124-130

https://doi.org/10.6696/IJHNS.201809_2(3).0005

摘要

Background: Field cancerization is common over the mucosa of the head and neck area among patients with smoking, alcohol consumption, or betel nut chewing habits. Methods: The study group included 55 patients. After completion of primary tumor resection, Lugol's staining solution was applied over the residual oral, oropharyngeal, and hypopharyngeal mucosa for detection of precancerous lesions. The Lugol-voiding areas were resected for pathological examination. Lugol's staining of excised tumors from 23 control lesions was used as a control. Results: One hundred fourteen lesions with Lugol-voiding mucosa were excised. The sensitivity, specificity, positive predictive value, and negative predictive value of Lugol's staining to detect mild (or greater) epithelial dysplasia intraoperatively were 100%, 85.2%, 96.5%, and 100%, respectively. Conclusions: The field cancerization is extensive among patients who have the habits of smoking and betel nut chewing. Lugol's staining is a useful, feasible, and cost-effective chemodetection agent for subclinical precancerous or cancerous lesions in the oral, hypopharyngeal, or oropharyngeal mucosa during surgery with acceptable sensitivity and specificity in detecting these abnormal mucosal lesions.

關鍵字

head and neck squamous cell carcinoma ； Lugol's iodine ； vital staining ； oral mucosal dysplasia ； surgical margin