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Apport de la cytologie œsophagienne et bronchique dans le suivi des cancéreux O.R.L.

The contribution of bronchial and oesophageal cytology in the follow-up of head and neck cancer

Aporte de la citología esófagica y bronquica en el seguimiento de los cánceres ORL

  • Published:
Acta Endoscopica

Résumé

Ľexistence de cancers multiples, simultanés ou successifs, sur la voie aéro-digestive supérieur (VADS) nous ont amené à établir un programme de dépistage afin de détecter les localisations tumorales métachrones à un stade précoce. Le but de cette étude est ďévaluer prospectivement ľapport ďun dépistage des cancers métachrones par des examens cytologiques bronchiques et œsophagiens lors ďun contrôle biannuel.

345 examens cytologiques des expectorations de 123 patients ont permis de découvrir 2 cancers bronchiques (prévalence = 1,6%) dont un cancer à un stade I, curable chirurgicalement. 4 tumeurs bronchiques furent diagnostiquées par une radiographie du thorax entre 6 et 12 mois, à des stades déjà avancés, après une cytologie négative. Le dépistage des cancers par la cytologie bronchique parait peu rentable dans les conditions où elles ont été réalisées.

Les 7 cytologies œsophagiennes positives sur 283 cytologies chez 108 patients ont toutes abouti à la découverte de tumeurs (9 tumeurs chez 5 patients) localisées aussi bien sur ľœsophage (45%) que dans le pharynx (55%). Leur diagnostic à un stade précoce dans le 78% des cas a permis des traitements curatifs et peu invasifs (tumorectomie au laser CO2, photothérapie). La cytologie abrasive de ľœsophage devient un complément indispensable au status local lors du suivi des cancéreux ORL.

Summary

The existence of multiple, simultaneous or successive cancers of the upper digestive tract and the airways led us to start a screening programme so as detect the metachronous tumoural localizations at an early stage. The aim of this study is to assess retrospectively the contribution of screening for metachronous cancers by bronchial and oesophageal cytological examinations during a biannual check-up.

345 cytological examinations of sputum from 123 patients led to the discovery of 2 bronchial cancers (prevalence =1.6%) of which one was at Stage I, and surgically curable. 4 tumours at advanced stages, were diagnosed by chest X rays, between 6 and 12 months, after a negative cytological examination. Screening for cancers by bronchial cytology does not seem to be very profitable in the conditions in which it was undertaken.

The 7 positive cytological examinations of the oesophagus out of the 283 performed in 108 patients, all resulted in the detection of tumours (9 tumours in 5 patients), located not only in the oesophagus (45 %) but also in the pharynx (55 %). Their diagnosis at an early stage in 78 % of the cases led to uninvasive, curative treatments (tumorectomy with CO2 laser, phototherapy). Brush cytology of the oesophagus has become a necessary complement to the local status during the follow-up of head and neck cancer patients.

Resumen

La existencia de cánceres múltiples, simultáneos o sucesivos, en la vía aéreo-digestiva superior (VADS) nos han llevado a establecer un programa de investigatión con el fin de detector las localizaciones tumorales metacronas en un estado precóz. El propósito de este estudio es evaluar prospectivamente el aporte de una investiagión de cánceres metacronos por examenes citológicos bronquiales y esofágicos después de un control bi-anual.

345 examenes citológicos de esputo de 123 patientes han permitido descubrir 2 cánceres bronquiales (prevalendo 1.6%) con un cáncer en estado 1, curable quirúrgicamente. 4 tumores bronquiales fueron diagnosticados por una radiografía de tórax entre 6 y 12 meses, en estados ya avanzados, después de una citología negativa. La investigatión de los cánceres por citología branquial parece poco rentable en las condiciones donde ellas han sido realizadas.

Las 7 citologías esofágicas positivas sobre 283 citologías en 108 patientes han llevado al descubrimiento de tumores (9 tumores en 5 patientes) localizados tanto en el esófago (45%) corno en la faringe (55%). Su diagnóstico en un estado precóz en el 78% de los casos ha permitido tratamientos curativos y poco invasivos (tumorectomía con laser CO2, fototerapia). La citología abrasiva del esófago se vuelve un complemento indispensable en el status local después del seguimiento de los cánceres ORL.

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Authors and Affiliations

  1. Service ďOto-rhino-laryngologie et de Chirurgie cervico-faciale, CHUV, Lausanne, Suisse

    Ph. Pasche, S. Pellissier & Ph. Monnier

  2. Institut universitaire de pathologie, Lausanne

    E. Gloor

Authors
  1. Ph. Pasche
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  2. S. Pellissier
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  3. E. Gloor
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  4. Ph. Monnier
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Pasche, P., Pellissier, S., Gloor, E. et al. Apport de la cytologie œsophagienne et bronchique dans le suivi des cancéreux O.R.L.. Acta Endosc 21, 631–640 (1991). https://doi.org/10.1007/BF02968560

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  • DOI: https://doi.org/10.1007/BF02968560

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