Résumé
La dysplasie est le terme qui désigne les lésions précancéreuses digestives, quels que soient l’étage du tube digestif et le type d’épithélium intéressés. Définie par l’OMS comme une lésion néoplasique certaine strictement limitée à l’épithélium, on peut considérer qu’elle est synonyme du terme de néoplasie intraépithéliale, largement employé dans d’autres organes, notamment la sphère génitale. Différentes classifications de la dysplasie se sont succédé, mais les classifications actuelles (classification de Vienne, classification de l’OMS) comprennent deux grades de sévérité croissante (bas grade et haut grade). Les pathologistes décrivent en outre des sous-types histologiques de dysplasie, plus ou moins fréquents selon l’étage du tube digestif, mais qui n’impactent que peu la prise en charge des patients. Le diagnostic de dysplasie peut être difficile. En plus de la coloration standard des biopsies, l’immunomarquage de la protéine p53 et de la protéine p16 peut aider à diagnostiquer et à classer une lésion dysplasique du tube digestif.
Abstract
Dysplasia is the term given to gastrointestinal precancerous lesions, irrespective of the stage of the gastrointestinal tract and the type of epithelium involved. Defined by the WHO as a clear neoplastic lesion, strictly limited to the epithelium, it may be regarded as synonymous with the term intra-epithelial neoplasm, which is widely used in other organs, particularly the genitals. Different dysplasia classifications have been used in the past, but the current ones (Vienna classification and WHO classification) include two grades of increasing severity (low grade and high grade). Furthermore, pathologists describe histological sub-types of dysplasia, which are more or less common depending on the position in the gastrointestinal tract, but which have only a limited impact on patient treatment. The diagnosis of dysplasia may be difficult. In addition to the standard staining of biopsies, immunomarking of the p53 protein and the p16 protein may help diagnose and classify a dysplastic lesion in the gastrointestinal tract.
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Flejou, JF. Dysplasie du tube digestif : définitions et difficultés de diagnostic. Acta Endosc 47, 151–153 (2017). https://doi.org/10.1007/s10190-017-0591-4
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DOI: https://doi.org/10.1007/s10190-017-0591-4