[Endoscopic detection of dysplasia and subclinical cancer of the esophagus. Results of a prospective study using toluidine blue vital staining in 100 patients with alcoholism and smoking].
In spite of the development of upper digestive tract fiberoptic endoscopy (FE) within the last 10 years, early detection of esophageal carcinoma (EC) is rare except in certain high-risk groups such as patients with head and neck cancers. The aim of this study was to assess the value of a meticulous histoendoscopic examination with vital toluidine blue (TB) staining in all alcohol and tobacco abusers undergoing FE for any reason except dysphagia. In 18 months, 100 patients (90 men, 10 women) who were over 40 years old and who consumed more than 80 g of alcohol and 20 g of tobacco per day underwent FE. No patient had a history of head and neck or esophageal cancer. FE was decided in 48 patients for epigastric pain, in 28 for esophageal varices, in 8 for weight loss, in 8 for anemia, in 7 for peptic disease, and in 1 for diarrhea. Staining with TB was carried out at the end of the examination and two routine biopsies were obtained 5 cm above the lower esophageal sphincter. Specimens were obtained from each abnormal area (TB + or TB -). Clinical ENT examination was recommended for all patients. Two esophageal carcinomas (1 microinvasive, 1 in situ) and 15 cases of dysplasia were detected. Dysplasia was classified as severe in 1 case, moderate in 9 cases, and mild in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Seitz
J F
JF
Service de Gastroentérologie, Institut Paoli-Calmettes, Marseille.
Monges
G
G
Navarro
P
P
Giovannini
M
M
Gauthier
A
A
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000517:prevention & control; D004945:Esophagoscopy; D004947:Esophagus / Q000002:abnormalities* / Q000473:pathology; D005260:Female; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011446:Prospective Studies; D012907:Smoking / Q000473:pathology*; D013997:Time Factors; D014048:Tolonium Chloride
D014048:Tolonium Chloride
Dépistage endoscopique des dysplasies et des cancers infracliniques de l'oesophage. Résultats d'une étude prospective avec coloration vitale par le bleu de toluidine chez 100 patients alcoolo-tabagiques.