Dysplasie: définition, signification et corrélation clinico-pathologique

Acta Endoscopica - Tập 30 - Trang 91-104 - 2000
K. Geboes1
1Department of Pathology, University Hospital K.U.Leuven, Leuven, Belgium

Tóm tắt

La dysplasie épithéliale du tractus gastro-intestinal est définie comme une “lésion néoplasique non équivoque” confinée à la membrane basale. La dysplasie est la phase initiale du développement du cancer et elle peut être reconnue en étude morphologique de routine. Le diagnostic de dysplasie est lié à la reconnaissance en routine d’anomalies cytologiques, et architecturales sur les coupes colorées à l’hématoxyline-éosine. Différents types de dysplasie peuvent être distingués. L’histologie permet de distinguer différents sous-groupes mais la dysplasie peut se développer sur un tissu d’apparence normale ou un tissu inflammatoire chronique et dans ce cas, elle peut faire suite à une métaplasie. La dysplasie peut-être subdivisée en différents degrés de sévérité, qui dépendent de l’intensité des anomalies cytologiques et architecturales. L’histoire naturelle de la dysplasie est peu connue et sa progression vers le cancer est une notion précieuse. Toutefois, en pratique, la dysplasie n’est pas toujours un précurseur de lésion précancéreuse. Elle peut aussi constituer un marqueur de cancer invasif déjà présent.

Tài liệu tham khảo

VAN DE VELDE C.J.H..—What is the best surgery for gastric cancer? In: International course on Digestive Oncology. Van Cutsem E; ed. University of Leuven, Leuven, 1995: 37–52. HARINGSMA J., TYTGAT G.N.J.,—Endoscopic localization of dysplasia in Barrett’s esophagus using ligh-induced fluorescence.Acta Gastroenterol. Belg., 1999,62, 17. GEBOES K.—Dysplasia in the gastrointestinal tract.Hepato-Gastroenterology, 1999,46, 657–660. GEBOES K., RUTGEERTS P.—Dysplasia in inflammatory bowel diseases: Definition and clinical impact.Can. J. Gastroenterol., in press RIDDELL R.H., GOLDMAN, H., RANSOHOFF D.F., APPELMAN H.D., FENOGLIO C.M., HAGITT R.C., AHREN C., CORREA P., HAMILTON S.R., MORSON B.C., SOMMERS S.C., YARDLEY J.H.—Dysplasia in inflammatory bowel disease: Standardized classification with provisional clinical applications.Human Pathol., 1983,14, 931–968. WARGOVICH M.J., PUREWAL M.—Biomarkers of Gastrointestinal Neoplasia. In: Gastrointestinal Cancers: Biology, Diagnosis and Therapy. Rustgi AK. ed. Lippincott-Raven Publishers, Philadelphia, 1995, 77–87. GEBOES K.—When is the esophageal mucosa normal? In: The Esophageal Mucosa. Giuli R, Tytgat GNJ, DeMeester TR, Galmiche JP. eds. Elsevier, Amsterdam, 1994: 21–28. HAUSTERMANS K.—In vivo growth kinetic measurements in human esophageal cancer. Thesis, KULeuven, 1995 IFTIKAR S.Y., STEELE R.J.C., WATSON S., JAMES P.D., DILKS K., HARDCASTLE J.D.—Assessment of proliferation of squamous, Barrett’s and gastric mucosa in patients with columnar lined Barrett’s oesphagus.Gut, 1992,33, 733–737. POTTEN C.S., KELLETT M., REW D.A., ROBERTS S.A. —Proliferation in human gastrointestinal epithelium using bromodeoxyuridine in vivo: Data for different sites, proximity to a tumour and polyposis coli.Gut, 1992,33, 524–529. HALL C., YOUNGS D., KEIGHLEY M.R.B.—Crypt cell production rates at various sites around the colon in Wistar rats and humans.Gut, 1992,33, 1528–1531. BIASCO G., PAGANELLI G.M., MIGLIOLI M., BARBARA L.— Cell proliferation in the gastrointestinal tract.J. Cell. Biochem. Suppl., 1992,16G, 73–78. ISAACSON P.—Biopsy appearances easily mistaken for malignancy in gastrointestinal endoscopy.Histopathology, 1982,6, 377–389. BERRY G.J., PITTS W.C., WEISS L.M.—Pseudomalignant ulcerative change of the gastrointestinal tract.Hum. Pathol., 1991,22, 59–62. JASS J.R., SOBIN L.H.—Histological typing of intestinal tumours. Springer Verlag, Berlin, 2nd ed, 1989: 3 FEARON E.R., VOGELSTEIN B.—A genetic model for colorectal tumorigenesis.Cell, 1990,61, 759–767. GEBOES K., ECTORS N.—Tumor progression. The multistep model. In: Introduction to tumor biology. I. De Wever ed. Leuven University Press, 1999: 73–92. ILYAS M., TOMLINSON I.P.M.—Genetic pathways in colorectal cancer.Histopathology, 1796,28, 389–399. VASEN H.F.A., BÜLOW S., MYRHOJ T., MATHUS-VLIEGEN L., GRIFFIOEN G., BUSKENS E., TAAL B.G., NAGENGAST F., SLORS J.F.M., DE RUITER P.—Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis.Gut, 1997,40, 716–719. SWEENY B.F., ANDERSON D.S.—Endoscopic removal of duodenal polyps in a patient with Gardner’s syndrome.Dig. Dis. Sci., 1982,27, 557–560. IIDA M., YAO T., ITOH H.et al.—Natural history of duodenal lesions in Japanese patients with familial adenomatosis coli (Gardner’s syndrome).Gastroenterology, 1989,96, 1301–1306. THOMAS M.G., NUGENT K.P., FORBES A., WILLIAMSON R.C. Calcipotriol inhibits rectal epithelial cell proliferation in ulcerative proctocolitis.Gut, 1994,35, 1718–1720. BAJAJ-ELLIOTT M., BREESE E., POULSOM R., FAIRCLOUGH P.D., MacDONALD T.T.—Keratinocyte growth factor in inflammatory bowel disease. Increased mRNA transcripts in ulcerative colitis compared with Crohn’s disease in biopsies and isolated mucosal myofibroblasts.Am. J. Pathol., 1997,151, 1469–1476 STOLTE M., Schneider A.—Differential diagnosis of adenomas and dysplasias in patients with ulcerative colitis. In: Inflammatory Bowel Diseases. Tytgat GNJ, Bartelsman JFWM, van Deventer SJH. eds. Kluwer Academic Publishers, Dordrecht, 1995: 133–144. TORRES C., ANTONIOLI D., ODZE R.—Polypoid dysplasia and adenomas in inflammatory bowel disease.Am. J. Surg. Pathol., 1998,22 275–284. JANKOWSKI J.A., WRIGHT N.A., MELTZER S., TRIADAFILOPOLOUS G., GEBOES K., CASSON A.G., KERR D., YOUNG L.S.—Molecular evolution of the metaplasia-dysplasia-adenocarcinoma sequence in the esophagus (MCS).Am. J. Pathol., 1999,154, 965–973. OEHLERT W.—Preneoplastic lesions of the stomach. In: Precursors of gastric cancer. Ming SC ed. New York, Praeger, 1984, 73–82. MORSON B.C. Precancer and cancer in inflammatory bowel disease.Pathology, 1985,17, 173–180. BATTS K.P., HAGGITT R.C.—Dysplasia in ulcerative colitis and Crohn’s disease: clinical pathology and current surveillance methods.In: Inflammatory bowel disease, from bench to bedside, SR Targan, F. Shanahan eds. Williams & Wilkins, Baltimore, 1994, 631–642. FAINTUCH J., LEVIN B., KIRSNER J.B.—Inflammatory bowel diseases and their relationship to malignancy.CRC Crit. rev. Oncol. Hematol., 1984,2, 323–353. BÜLOW S.—Familial adenomatosis polyposis coli.Ann. Med., 1989,21, 299–307. MECKLIN J.P., JARVINEN H.J. Clinical features of colorectal carcinoma in cancer family syndrome.Dis. Colon Rectum, 1986,29, 160–164. STRYKER S.J., WOLFF B.G., CULP C.E.et al.—Natural history of untreated colonic polyps.Gastroenterology, 1987,93, 1009–1013. WOLBER R.A., OWEN D.A.—Flat adenomas of the colon.Hum. Pathol., 1991,22, 70–74. HAMEETEMAN W., TYTGAT G.N.J., HOUTHOFF H.J., VAN DEN TWEEL J.G.—Barrett’s esophagus: development of dysplasia and adenocarcinoma.Gastroenterology, 1989,96, 1249–1256. REID B.J., BLOUNT P.L., RUBIN C.E., LEVINE D.S., HAGGITT R.C., RABINOVITCH P.S.—Flow-cytometric and histological progression to malignancy in Barrett’s esophagus: prospective endoscopic surveillance of a cohort.Gastroenterology, 1992,102, 1212–1219. MIROS M., KERLIN P., WALKER N.—Only patients with dysplasia progress to adenocarcinoma in Barrett’s oesophagus.Gut, 1991,32, 1441–1446. LERUT T., COOSEMANS W., VAN RAEMDONCK D., DILLEMANS B., DELEYN P., MARNETTE J.M., GEBOES K.—Surgical treatment of Barrett’s carcinoma. Correlations between morphologic findings and prognosis.J. Thorac. Cardiovasc. Surg., 1994,107, 1059–1065. REID BJ.—Barrett’s esophagus and esophageal adenocarcinoma.Clin. Gastroenterol., 1991,20, 817–833. LEVINE D.S., HAGGITT R.C., IRVINE S., REID B.J.— Natural history of high-grade dysplasia in Barrett’s Esophagus.Gastroenterology, 1996,110, A550. PETERS F.T.M., KLEIBEUKER J.H.—Barrett’s esophagus. and carcinoma. Recent insights into its development and possible prevention.Scand. J. Gastroenterol., 1993,28 s200, 59–64. PHILLIPS R.W., WONG R.K.H.—Barrett’s esophagus. Natural history, incidence, etiology and complications.Clin. gastroenterol., 1991,20, 791–816. ROSENSTOCK E., FARMER R.G., PETRAS R., SIVAK M.V., RANKIN G.B., SULLIVAN B.H.—Surveillance for colonic carcinoma in ulcerative colitis.Gastroenterology, 1985,89, 1342–1346. WOOLRICH A.J., DASILVA M.D., KORELTIZ B.I.—Surveillance in the routine management of ulcerative colitis: the predictable value of low-grade dysplasia.Gastroenterology, 1992,161, 431–438.