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Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer
BACKGROUND/AIM: The dramatic color change after iodine staining (from white-yellow to pink after 2–3 min), designated as the “pink-color sign” (PCS), is indicative of esophageal high-grade intraepithelial neoplasia (HGIN) or an invasive lesion. However, no study has yet examined the association betw...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457187/ https://www.ncbi.nlm.nih.gov/pubmed/30588952 http://dx.doi.org/10.4103/sjg.SJG_274_18 |
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author | Zheng, Jia-Yao Chen, Ya-Hua Chen, Yang-Yang Zheng, Xiao-Ling Zhong, Shi-Shun Deng, Wan-Yin Zheng, Jin-Hui Guo, Xian-Bin Gao, Li-Ying Liang, Wei |
author_facet | Zheng, Jia-Yao Chen, Ya-Hua Chen, Yang-Yang Zheng, Xiao-Ling Zhong, Shi-Shun Deng, Wan-Yin Zheng, Jin-Hui Guo, Xian-Bin Gao, Li-Ying Liang, Wei |
author_sort | Zheng, Jia-Yao |
collection | PubMed |
description | BACKGROUND/AIM: The dramatic color change after iodine staining (from white-yellow to pink after 2–3 min), designated as the “pink-color sign” (PCS), is indicative of esophageal high-grade intraepithelial neoplasia (HGIN) or an invasive lesion. However, no study has yet examined the association between the time of PCS appearance and histopathology. We investigated the association between the time of PCS appearance and esophageal histopathology in 456 lesions of 438 patients who were examined for suspected esophageal cancer. MATERIALS AND METHODS: The records of 495 consecutive patients who had suspected esophageal cancer based on gastroscopy and who underwent Lugol's chromoendoscopy from January 2015 to March 2018 were retrospectively reviewed. The time of PCS appearance was recorded in all patients, and tissue specimens were examined. RESULTS: We examined 456 lesions in 438 patients. Use of PCS positivity at 2 min for the diagnosis of HGIN/invasive cancer had a sensitivity of 84.1%, a specificity of 72.7%, and an accuracy of 80.4%. We classified the PCS-positive patients in whom the time of PCS appearance was recorded (168 lesions) into 4 groups: 0–30, 31–60, 61–90, and 91–120 s. Based on a 60-s time for appearance of the PCS, the area under the receiver operating characteristic curve was 0.897, indicating good validity. At the optimal cutoff value of 60 s, the sensitivity was 90.2% and the specificity was 82.3%. The appearance of the PCS within 60 s had a diagnostic accordance rate of 88.6%, significantly higher than appearance of the PCS within 2 min (79.7%, P < 0.05). CONCLUSION: Appearance of the PCS within 1 min after iodine staining has a higher diagnostic accordance rate for esophageal HGIN/invasive cancer than appearance of the PCS at 2 min. |
format | Online Article Text |
id | pubmed-6457187 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-64571872019-04-18 Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer Zheng, Jia-Yao Chen, Ya-Hua Chen, Yang-Yang Zheng, Xiao-Ling Zhong, Shi-Shun Deng, Wan-Yin Zheng, Jin-Hui Guo, Xian-Bin Gao, Li-Ying Liang, Wei Saudi J Gastroenterol Original Article BACKGROUND/AIM: The dramatic color change after iodine staining (from white-yellow to pink after 2–3 min), designated as the “pink-color sign” (PCS), is indicative of esophageal high-grade intraepithelial neoplasia (HGIN) or an invasive lesion. However, no study has yet examined the association between the time of PCS appearance and histopathology. We investigated the association between the time of PCS appearance and esophageal histopathology in 456 lesions of 438 patients who were examined for suspected esophageal cancer. MATERIALS AND METHODS: The records of 495 consecutive patients who had suspected esophageal cancer based on gastroscopy and who underwent Lugol's chromoendoscopy from January 2015 to March 2018 were retrospectively reviewed. The time of PCS appearance was recorded in all patients, and tissue specimens were examined. RESULTS: We examined 456 lesions in 438 patients. Use of PCS positivity at 2 min for the diagnosis of HGIN/invasive cancer had a sensitivity of 84.1%, a specificity of 72.7%, and an accuracy of 80.4%. We classified the PCS-positive patients in whom the time of PCS appearance was recorded (168 lesions) into 4 groups: 0–30, 31–60, 61–90, and 91–120 s. Based on a 60-s time for appearance of the PCS, the area under the receiver operating characteristic curve was 0.897, indicating good validity. At the optimal cutoff value of 60 s, the sensitivity was 90.2% and the specificity was 82.3%. The appearance of the PCS within 60 s had a diagnostic accordance rate of 88.6%, significantly higher than appearance of the PCS within 2 min (79.7%, P < 0.05). CONCLUSION: Appearance of the PCS within 1 min after iodine staining has a higher diagnostic accordance rate for esophageal HGIN/invasive cancer than appearance of the PCS at 2 min. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6457187/ /pubmed/30588952 http://dx.doi.org/10.4103/sjg.SJG_274_18 Text en Copyright: © 2018 Saudi Journal of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Zheng, Jia-Yao Chen, Ya-Hua Chen, Yang-Yang Zheng, Xiao-Ling Zhong, Shi-Shun Deng, Wan-Yin Zheng, Jin-Hui Guo, Xian-Bin Gao, Li-Ying Liang, Wei Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
title | Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
title_full | Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
title_fullStr | Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
title_full_unstemmed | Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
title_short | Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
title_sort | presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457187/ https://www.ncbi.nlm.nih.gov/pubmed/30588952 http://dx.doi.org/10.4103/sjg.SJG_274_18 |
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