Early detection of neoplasia of the esophagus and gastroesophageal junction.
World Congress of Gastroenterology. Los Angeles USA, 1994.
Recommendations for preventing adenocarcinoma :
The standard definition of Barrett's epithelium should be the presence of intestinalized mucosa in the lower esophagus.
Patients in this category should be considered for inclusion in a screening program for the detection of dysplasia or carcinoma.
Those who are a poor operative risk should not be screened if the detection of an endpoint such as high-grade dysplasia or intramucosal carcinoma will still not lead to resection.
In some centers, however, alternative experimental methods of mucosal ablation may be available.
The endpoint for screening is invasive or intramucosal carcinoma (or-in centers with a very low operative mortality-high-grade dysplasia).
These should lead to consideration of surgery or, in specialized centers and as part of controlled studies, newer alternative modes of epithelial ablation.
Intermediate markers, e.g., use of aneuploidy, gene markers, or their products, are at present experimental.
Screening should be carried out annually or, possibly, biennially.
This screening should utilize a standard protocol with an endoscope capable of obtaining large-particle biopsies.
Four quadrant biopsies should be taken about every 2 cm, beginning 2 cm above the proximal limit of the gastric rugae, continuing until unequivocally in squamous mucosa, and following any tongues of glandular epithelium.
Recommendations for prevention of squamous carcinoma : In high-risk populations, esophageal cytology...
Mots-clés Pascal : Adénocarcinome, Oesophage, Oesophage Barrett, Jonction oesogastrique, Epidémiologie, Exploration, Homme, Tumeur maligne, Appareil digestif pathologie, Oesophage pathologie
Mots-clés Pascal anglais : Adenocarcinoma, Esophagus, Barrett esophagus, Gastroesophageal junction, Epidemiology, Exploration, Human, Malignant tumor, Digestive diseases, Esophageal disease
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Cote : 96-0279378
Code Inist : 002B30A01C. Création : 199608.