Endoscopic thermometry in healthy controls and in gastroesophageal malignancy

A thermocouple passed through the biopsy channel of an upper gastrointestinal fiberscope was used to measure mucosal temperature in health and disease. We documented significant mucosal temperature differences at nine sites in 32 normal controls. Duodenal bulb, stomach and the esophagus were warmer than the sublingual site. Mid-esophagus was warmer than the distal esophagus. Next, patients with 50 histologically benign gastric ulcers (GU) were compared with 18 malignant GU containing adeno-div carcinoma. In benign GU there was a marked temperature gradient between a normal reference site (lesser curvature) and a warmer edge (+0.47 degrees C, p less than 0.01) and the crater (+0.73 degrees C, p less than 0.001) of the ulcer. Malignant GU showed no difference to the reference site. In thirteen patients with esophageal cancer, the tumor and also the adjacent mucosa proximal and distal to the tumor were cooler than the corresponding sites in normal controls. Upper GI malignancy appears to have a cooler mucosa. This pattern differs from normal and from non-malignant inflammation. These results support the need for further evaluation of the diagnostic potential of mucosal thermometry, especially of infrared videoendoscopy. (Fig. 1, Tab. 3, Ref. 10).