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Acta Endoscopica

, Volume 22, Issue 5, pp 497–505 | Cite as

Lésions malignes en métaplasie cylindrique œsophagienne

  • G. N. J. TYTGAT
Article
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Résumé

La métaplasie cylindrique œsophagienne constitue une « mosaïque » de cellules, glandes, et types architecturaux, offrant des degrés variables de maturité, allant de l’épithélium intestinal au type gastrique. La dysplasie correspond à une altération néoplasique indiscutable de l’épithélium. La dysplasie de haut-degré (sévère) consiste en modifications cellulaires et/ou architecturales néoplasiques au niveau de l’épithélium cylindrique, en l’absence d’envahissement de la membrane basale. La prévalence de la dysplasie varie habituellement entre 5 et 10 %. La dysplasie s’observe spécialement au niveau de l’épithélium cylindrique de type spécialisé ou de type intestinal. La dysplasie sévère constitue un marqueur de malignité potentielle ou déjà présente. Au moment du diagnostic, la majorité des lésions adénocarcinomateuses sont à un stade invasif. L’infiltration tumorale transmurale s’observe dans 60 à 88 % des cas et l’envahissement des ganglions lymphatiques dans 55 à 74 % des cas. Le pronostic est médiocre, avec une faible survie à 5 ans. Les évaluations de la prévalence du cancer dans les études sur populations surveillées, varient de 1 sur 52 à 441 patients/année de surveillance.

Summary

Esophageal columnar metaplasia is a « mosaic » of cells, glands, and architectural types, showing variable degrees of maturation towards intestinal or gastric type épithélium. Dysplasia refers to an unequivocally neoplastic alteration in the épithélium. High- grade (severe) dysplasia consists of neoplastic cellular and/or architectural changes within the columnar épithélium, without invasion through the basement membrane. The prevalence of dysplasia is usually around 5- 10 %. Dysplasia has been found especially in the specialized columnar- or intestinal epithelial type. Severe dysplasia is a marker of impending or already present malignancy. At the time of diagnosis most adenocarcinomata are advanced. Transmural tumor infiltration is found in 60- 88 %, and lymph node invasion in 55- 74 % of cases. The prognosis is poor with a low 5 year survival. Estimates of prevalence of cancer in surveillance studies vary from 1 case per 52 to 441 patient years of follow-up.

Mots-clés

adénocarcinome dysplasie œsophage de Barrett métaplasie cylindrique 

Key-words

adenocarcinoma Barrett’s esophagus columnar metaplasia dysplasia 

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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • G. N. J. TYTGAT
    • 1
  1. 1.Academic Medical CenterAmsterdamThe Netherlands

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