[Preoperative evaluation of cancers of the esophagus. Contribution of in vivo staining].
OBJECTIVE
We assessed the effectiveness of a dye-endoscopy to detect inapparent multicentric carcinomas of the oesophagus.


METHODS
The study included 95 patients scheduled for oesophagectomy. A lugol stain was applied to the oesophageal mucosa and any non-stained area was biopsied. The proximal oesophagus was reexamined on the pathology specimen obtained after oesophagectomy.


RESULTS
Intramucosal epithelioma of the proximal oesophagus was found in 7 patients (7.4%) and severe dysplasia was seen in 3 (3.1%). Abnormal stains were seen in 33 patients including 9 with diffuse parakeratosis. There were 24 focal anomalies including 6 cases of intramucosal carcinoma, 3 severe dysplasias, 3 gastric metaplasias and 12 parakeratoses. One intramucosal epithelioma observed on the surgical specimen had not been detected by the staining technique. Overall sensitivity was 85.7% and specificity was 71.7%. Including focal anomalies only, specificity was 79.5%.


CONCLUSIONS
Vital staining is a useful tool for pre-operative assessment of cancer of the oesophagus, in particular for superficial forms.
Massard
G
G
Service de Chirurgie thoracique, Hôpitaux universitaires de Strasbourg.
Dabbagh
A
A
Vetter
D
D
Gasser
B
B
Dumont
P
P
Wihlm
J M
JM
Morand
G
G
D000328:Adult; D000368:Aged; D001706:Biopsy; D016145:Endoscopy, Digestive System / Q000379:methods*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011859:Radiography; D013194:Staining and Labeling / Q000379:methods*