Résumé
La dysplasie se définit comme un état prénéoplasique s’exprimant par des anomalies tissulaires architecturales et des atypies cytologiques confinées à l’épithélium.
Après avoir défini les différents critères histologiques et cytologiques de la dysplasie dans l’épithélium œsophagien, les auteurs passent en revue la classification ancienne en trois grades: léger, modéré et sévère et son évolution vers une classification simplifiée en bas et haut grade.
L’évidence de l’association dysplasie-cancer et le rôle de la dysplasie dans la cancérogenèse œsophagienne reposent sur plusieurs types d’études: épidémiologique (géographique et de suivi) ou encore morphologique, résultant d’études approfondies de pièces opératoires.
Bien que la dysplasie œsophagienne soit rare dans nos contrées, étant donné son bon pronostic, sa recherche s’impose chez les patients à risque par une méthode rigoureuse associant la coloration vitale endoscopique à la cytologie et à la biopsie.
Summary
Dysplasia can be defined as a preneoplastic lesion characterized by tissular architectural anomalies and cytological changes which remain confined to the epithelium.
After a short description of the different histological and cytological criteria of esophageal squamous dysplasia, the authors review the old classifications in three grades: mild, moderate and severe and their evolution towards a simplified two tier classification in low and high grade.
The evidence of an association between dysplasia and cancer and the role of dysplasia in esophageal carcinogenesis rely upon several types of studies: epidemiological (geographical and follow-up studies) as well as morphological (based on detailed investigations of surgical specimens).
Although esophageal dysplasia is rare in our countries, in populations at risk, taking into account its excellent prognosis, a rigorous screening methodology must be used associating endoscopic vital staining with cytology and histology.
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Jouret, A., Haot, J. Dysplasie de l’épithélium pavimenteux ooesophagien. Acta Endosc 30, 115–121 (2000). https://doi.org/10.1007/BF03022278
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DOI: https://doi.org/10.1007/BF03022278