Cynthia, Susan Mathew (2020) A Prevalence of Synchronous Oesophageal Cancers in patient with Head and Neck Cancers. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: Patients with head and neck cancers have a high risk of developing second primary cancers like oesophageal cancers. Synchronous oesophageal cancers are diagnosed with the help of white light endoscopy, narrow band imaging and Lugol’s chromoendoscopy. Early diagnosis of these lesions improve the prognosis and outcome of patients with head and neck cancers. OBJECTIVES: 1. To evaluate the prevalence of synchronous esophageal cancer in patients diagnosed with head and neck cancer using Narrow Band imaging and Lugol’s Chromoendoscopy 2. To assess the risk factors associated with synchronous esophageal cancer in patients diagnosed with head and neck cancer. MATERIALS AND METHODS: A total of 63 patients who were diagnosed with biopsy proven head and neck cancer patients presenting to ENT OPD were recruited. Informed valid consent was taken. All recruited patients underwent Upper GI White light Endoscopy, Narrow Band imaging upper GI Endoscopy and Lugol’s chromoendoscopy in Gastroenterology Department. The suspected areas of mucosa were biopsied and sent for histopathological examination. RESULTS: Synchronous oesophageal cancer was not identified with the help of white light endoscopy, Narrow band imaging or Lugol’s chromoendoscopy. Using white light endoscopy, there were no suspicious lesions seen in the oesophagus and hence biopsies were not taken. On NBI, 3 patients showed thickened and crowded IPCL Type 1 pattern - 2 biopsies reported as reflux esophagitis and 1 epithelial hyperplasia. One patient had IPCL type 2 pattern for which biopsy was taken and was normal. Biopsy of unstained mucosa using Lugol’s chromoendoscopy in 7 patients was reported as gastric metaplasia, epithelial hyperplasia and high grade dysplasia in one each, two patients showed mild chronic oesophagitis and two as normal biopsy. The most common risk factors in patients with head and neck cancers were cigarette smoking, followed by betel nut chewing and alcohol intake. CONCLUSION: Synchronous oesophageal malignancy was not detected in patients with head neck cancers at the time of diagnosis. Keeping in mind the major risk factors which are smoking, betel nut chewing followed by alcohol intake and other factors like age, staging of cancer , the site of primary head and neck cancer, regular screening of the oesophagus with the help of endoscopy and periodic follow up upto 6 months is required. White light endoscopy is cost effective and does not require skilled expertise for interpretation. While performing the while light endoscopy as a screening procedure, the suspected lesions may be correlated using Narrow Band imaging and Lugol’s chromoendoscopy to improve the identification of synchronous lesions and premalignant lesions.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221714351 |
| Uncontrolled Keywords: | Synchronous oesophageal cancer, narrow band imaging, Lugol’s chromoendoscopy. |
| Subjects: | MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Feb 2021 05:16 |
| Last Modified: | 15 Feb 2021 05:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14234 |
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