Natural Course of Esophageal Dysplasia Detected in Mass Screening Programs Tai Ohmori 1,4 , Yoshiya Kumagai 2 , Hiroyasu Makuuchi 1,3 1Keio Cancer Detection Center 2Mitsukoshi Clinic 3Department of Surgery, Tokai University School of Medicine Keyword: 食道dysplasia , ヨード染色 , 頻度 , 形態 , 経過観察 , 対策 pp.175-184
Published Date 1991/2/25
DOI https://doi.org/10.11477/mf.1403102458
  • Abstract
  • Look Inside

 A total of 593 cases of iodine unstained areas in the esophagus were detected by esophagoscopic examination in mass screening programs over the past 6 years at Keio Cancer Detection Center and Mitsukoshi Clinic. Diagnosis of dysplasia was made in 47 among these 593 cases. The frequency of areas unstained by iodine was 1.6-3.6%, and that of dysplasias 0.1-0.3% in our two institutions. There are 3 characteristics noted for dysplasia. (1) Most dysplasia is detected only by iodine staining, and it is almost impossible to distinguish between dysplasia and normal epithelium by esophagoscopy without iodine method. (2) Dysplasia presents itself as areas unstained by iodine, clearly demarcated and white in color. (3) Most dysplasia is larger than 5 mm in diameter. Extensive follow-up of these 47 dysplasia cases showed that diameter increased in 13 cases doring the period of observation.Five of these 13 cases developed intraepithelial cancer. In another 3 of 13 cases in which dysplasia was severe on the first biopsy followed by carcinoma on the next biopsy. Cancer was resected in all these 8 cases either by thoracotomyor esophagofiberscope. Pathologically they were all early cancers. Esophageal dysplasia is therefore considered to be precancerous state, and we should make efforts to detect it to improve the prognosis of esophageal cancer.

Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院