[Analysis on the effect of iodine staining endoscopy in screening for early esophageal cancer]

Objective: To analyze the effect of iodine staining endoscopy in the screening of esophageal early cancer. Methods: The clinical data of people who underwent gastroscopy from January 1, 2019 to December 31, 2023 in Xuyi People's Hospital affiliated to Kangda College of Nanjing Medical University were retrospectively analyzed. According to whether the esophagus was stained with Lugo's iodine solution, the patients were divided into iodine staining group (Lugo's iodine solution staining) and non-iodine staining group. According to the years of operation, endoscopists were divided into less experienced endoscopists (<10 years) and experienced endoscopists (≥10 years). The basic characteristics of the patients in the iodine staining group and the non-iodine staining group were compared, and the differences in the detection rates of low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN) and early esophageal cancer among endoscopists with iodine staining and different years of experience were compared. Results: A total of 9 918 patients were enrolled, including 4 564 males and 5 354 females, with age of (57.3±7.3) years. There were 4 965 cases [2 312 males and 2 653 females, aged (57.4±7.4) years] in the non-iodine staining group. There were 4 953 patients [2 252 males and 2 701 females, aged (57.2±7.2) years] in the iodine staining group. There was no significant difference in sex and age between the two groups (both P>0.05). The detection rate of esophageal LGIN [0.3% (5/4 965) vs 3.2% (159/4 953)], the detection rate of HGIN [0.2% (10/4 965) vs 0.7% (32/4 953)] and the detection rate of early case [0.2% (12/4 965) vs 0.7% (35/4 956)] in the non-iodine staining group were lower than those in the iodine staining group (all P<0.001). There was no significant difference in the detection rate of early esophageal cancer between the two groups [0.0% (2/4 965) vs 0.1% (3/4 953), P>0.05]. In the non-iodine staining group, the detection rate of esophageal LGIN [0.6% (12/1 991) vs 0.1% (3/2 974)], the detection rate of HGIN [0.4% (8/1 991) vs 0.1% (2/2 974)], the detection rate of early case [0.5% (9/1 991) vs 0.1% (3/2 974)], and the positive rate of biopsy [35.3% (9/1 991) vs 13.6% (30/2 974)] in the experienced endoscopists were all higher than those of the less experienced endoscopists (all P<0.05). There was no significant difference in the detection rate of early-stage esophageal cancer between the two groups [0.0% (1/2 974) vs 0.1% (1/1 991), P=0.279]. In the iodine staining group, there were no statistical difference in the detection rates of LGIN, HGIN, early-stage esophageal cancer and early cases between the experienced endoscopists and the less experienced endoscopists (all P>0.05). Conclusion: Iodine staining endoscopy can improve the detection rate of early esophageal cancer and precancerous lesions, especially for less experienced endoscopists.