Zusammenfassung
Karzinome des Magen-Darm-Trakts (MDT) sind häufig. Auch wenn die Inzidenz von Kolonkarzinomen und Magenkarzinomen in der Schweiz sinkt, gehören beide doch zu den häufigsten bösartigen Tumoren. In der Schweiz beträgt die Mortalität für Kolonkarzinome pro Jahr für Männer 13,8/100.000 und 8,26/100.000 für Frauen. Die Inzidenz der Magenkarzinome nimmt schon seit langem deutlich ab; die Zahl der Ösophaguskarzinome und Dünndarmkarzinome ist in der Schweiz, ähnlich wie in anderen Industriestaaten, relativ gering.
Anders ist die Situation in weniger entwickelten Ländern. Das Ösophaguskarzinom ist beispielsweise in manchen Regionen Südostasiens der häufigste maligne Tumor überhaupt. Daher werden in China zytologische Untersuchungen in großem Stil zur Früherkennung des Ösophaguskarzinoms eingesetzt [10].
In Standardwerken der gastrointestinalen Pathologie wird der zytologischen Diagnostik trotzdem nur ein geringer Stellenwert zuerkannt, denn in kaum einem anderen Gebiet der klinischen Zytopathologie ist die Gefahr falsch-positiver Diagnosen so groß wie im MDT. Will man falsch-positive Befunde vermeiden, ist Vorsicht geboten. So gelangt man häufig nicht über eine Verdachtsdiagnose hinaus. Werden die zweifelhaften zytologischen Befunde aber vor dem klinischen Hintergrund und im Lichte der histologischen Befunde interpretiert und bewertet, sind zytologische Untersuchungen dennoch oft eine wertvolle Ergänzung der Gewebebiopsie.
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Literatur
Alexander JA, Cuellar RE, Fadden RJ et al. (1988) Cytomegalovirus infection of the upper gastrointestinal tract before and after liver transplantation. Transplantation 46: 378–382
Anandasabapathy S, Jhamb J, Davila M et al. (2007) Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia. Cancer 109: 668–674
Anderson LA, Watson RG, Murphy SJ et al. (2007) Risk factors for Barrett’s oesophagus and oesophageal adenocarcinoma: results from the FINBAR study. World J Gastroenterol 13: 1585–1594
Baretton G, Carstensen O, Schardey M et al. (1991) DNA-ploidy and survival in gastric carcinomas: a flow-cytometric study. Virchows Arch A Pathol Anat Histopathol 418: 301–309
Barrett NR (1950) Chronic peptic ulcer of the oesophagus and „oesophagitis“. Br J Surg 38: 175–182
Berry AV, Baskind AF, Hamilton DG (1981) Cytologic screening for esophageal cancer. Acta Cytol 25: 135–141
Boon ME, Kurver PJ, Baak JP et al. (1981) The application of morphometry in gastric cytological diagnosis. Virchows Arch A Pathol Anat Histol 393: 159–164
Borchard F, Heilmann KL, Hermanek P et al. (1991) Definition und klinische Bedeutung der Dysplasie im Verdauungstrakt. Ergebnisse einer Sitzung der Arbeitsgemeinschaft Gastroenterologische Pathologie am 25.11.1989 in Kronberg. Pathologe 12: 50–56
Bottger TC, Gabbert HE, Stockle M et al. (1992) DNA image cytometry: a prognostic tool in rectal cancer? Dis Colon Rectum 35: 436–443
Boyle P, Levin BH (2008) World Cancer Report 2008. WHO, IARC Press, Lyon
Brien TP, Odze RD, Sheehan CE et al. (2000) HER-2/neu gene amplification by FISH predicts poor survival in Barrett‘s esophagus-associated adenocarcinoma. Hum Pathol 31: 35–39
Cardillo MR and Agnelli M (1990) Brush cytology in the endoscopic diagnosis of benign gastric ulcers. A useful adjunct to biopsy? Arch Anat Cytol Pathol 38: 86–91
Carneiro F, Moutinho-Ribeiro M, David L et al. (1992) Signet ring cell carcinoma of the stomach: a morphometric, ultrastructural, DNA cytometric study. Ultrastruct Pathol 16: 603–614
Chang F, Syrjanen S, Shen Q et al. (1990) Human papillomavirus (HPV) DNA in esophageal precancer lesions and squamous cell carcinomas from China. Int J Cancer 45: 21–25
Chen YL (1987) The diagnosis of colorectal cancer with cytologic brushings under direct vision at fiberoptic colonoscopy. A report of 59 cases. Dis Colon Rectum 30: 342–344
Chu PG, Weiss LM (2004) Immunohistochemical characterization of signet-ring cell carcinomas of the stomach, breast, colon. Am J Clin Pathol 121: 884–892
Claren R, Isimbaldi G, Pallino A et al. (1990) Identification of Campylobacter pylori by gastric brush cytology. Diagn Cytopathol 6: 223–224
Cook IJ, de Carle DJ, Haneman B et al. (1988) The role of brushing cytology in the diagnosis of gastric malignancy. Acta Cytol 32: 461–464
Cusso X, Mones J, Ocana J et al. (1993) Is endoscopic gastric cytology worthwhile? An evaluation of 903 cases of carcinoma. J Clin Gastroenterol 16: 336–339
Darragh TM (2004) Anal cytology for anal cancer screening: is it time yet?. Diagn Cytopathol 30: 371–374
Dawsey SM, Lewin KJ, Wang GQ et al. (1994) Squamous esophageal histology and subsequent risk of squamous cell carcinoma of the esophagus. A prospective follow-up study from Linxian, China. Cancer 74: 1686–1692
Deans GT, Williamson K, Hamilton P et al. (1993) DNA densitometry of colorectal cancer. Gut 34: 1566–1571
Debongnie JC, Delmee M, Mainguet P et al. (1992) Cytology: a simple, rapid, sensitive method in the diagnosis of Helicobacter pylori. Am J Gastroenterol 87: 20–23
Defrain C, Chang CY, Srikureja W et al. (2005) Cytologic features and diagnostic pitfalls of primary ampullary tumors by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer 105: 289–297
Desoubeaux N, Le Prieur A, Launoy G et al. (1999) Recent time trends in cancer of the oesophagus and gastric cardia in the region of Calvados in France, 1978-1995: a population based study. Eur J Cancer Prev 8, 479–486
Dimagno EP, Regan PT, Clain JE et al. (1982) Human endoscopic ultrasonography. Gastroenterology 83: 824–829
Dina R, Cassisa A, Baroncini D et al. (1992) Role of esophageal brushing cytology in monitoring patients treated with sclerotherapy for esophageal varices. Acta Cytol 36: 477–479
Dirschmid K, Walser J, Hugel H (1984) Pseudomalignant erosion in hyperplastic gastric polyps. Cancer 54: 2290–2293
Dowlatshahi K, Skinner DB, DeMeester TR et al. (1985) Evaluation of brush cytology as an independent technique for detection of esophageal carcinoma. J Thorac Cardiovasc Surg 89: 848–851
Dunsche A, Harle F (2000) Precancer stages of the oral mucosa: a review. Laryngorhinootologie 79: 423–47
Eckardt VF, Fuchs M, Kanzler G et al. (1988) Follow-up of patients with colonic polyps containing severe atypia and invasive carcinoma. Compliance, recurrence, survival. Cancer 61: 2552–2557
Ehya H, O‘Hara BJ (1990) Brush cytology in the diagnosis of colonic neoplasms. Cancer 66: 1563–1567
Erickson RA, Sayage-Rabie L, Beissner RS (2000) Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies. Gastrointest Endosc 51: 184–190
Falk GW, Chittajallu R, Goldblum JR et al. (1997) Surveillance of patients with Barrett‘s esophagus for dysplasia and cancer with balloon cytology. Gastroenterology 112: 1787–1797
Feichter GE (1984) Vergleichende DNS-durchflusszytometrische Untersuchungen an ausgewählten soliden menschlichen Tumoren. Habilitationsschrift Medizinische Fakultät, Ruprecht-Karls-Universität, Heidelberg
Festa VI, Hajdu SI, Winawer SJ (1985) Colorectal cytology in chronic ulcerative colitis. Acta Cytol 29: 262–268
Filipe MI, Rosa J, Sandey A et al. (1991) Is DNA ploidy and proliferative activity of prognostic value in advanced gastric carcinoma?. Hum Pathol 22: 373–378
Friedlander MA, Stier E, Lin O (2004) Anorectal cytology as a screening tool for anal squamous lesions: cytologic, anoscopic, histologic correlation. Cancer 102: 19–26
Gordon IL, Rypins EB, Wuerker RB et al. (1991) Cytologic detection of colorectal cancer after administration of oral lavage solution. Cancer 68: 106–110
Green LK, Zachariah S, Graham DY (1990) The use of gastric salvage cytology in the diagnosis of malignancy: a review of 731 cases. Diagn Cytopathol 6: 1–4
Hamilton SR, Smith RR (1987) The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett‘s esophagus. Am J Clin Pathol 87: 301–312
Henning N, Witte S (1970) Atlas of gastrointestinal Cytodiagnosis. Thieme, Stuttgart
Hoda SA, Hajdu SI (1992) Small cell carcinoma of the esophagus. Cytology and immunohistology in four cases. Acta Cytol 36: 113–120
Howson CP, Hiyama T, Wynder EL (1986) The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev 8: 1–27
Isaacson P (1982) Biopsy appearances easily mistaken for malignancy in gastrointestinal endoscopy. Histopathology 6: 377–389
Jacob P, Kahrilas PJ, Desai T et al. (1990) Natural history and significance of esophageal squamous cell dysplasia. Cancer 65: 2731–2739
Jain S, Filipe MI, Hall PA et al. (1991) Prognostic value of proliferating cell nuclear antigen in gastric carcinoma. J Clin Pathol 44: 655–659
Jeevanandam V, Treat MR, Forde KA (1987) A comparison of direct brush cytology and biopsy in the diagnosis of colorectal cancer. Gastrointest Endosc 33: 370–371
Jessurun J, Paplanus SH, Nagle RB et al. (1986) Pseudosarcomatous changes in inflammatory pseudopolyps of the colon. Arch Pathol Lab Med 110: 833–836
Jhala NC, Jhala D, Eltoum I et al. (2004) Endoscopic ultrasound-guided fine-needle aspiration biopsy: a powerful tool to obtain samples from small lesions. Cancer 102: 239–246
Jhala NC, Jhala DN, Chhieng DC et al. (2003) Endoscopic ultrasound-guided fine-needle aspiration. A cytopathologist’s perspective. Am J Clin Pathol 120: 351–367
Kannan V and Masters CB (1991) Cytodiagnosis of colonic adenoma: morphology and clinical importance. Diagn Cytopathol 7: 366–372
Kayabali I, Gokcora IH, Bacaci K et al. (1992) Primary colonic non-Hodgkin lymphomas: a retrospective clinicopathologic study of 14 cases. Int Surg 77: 195–197
Kimura H and Yonemura Y (1991) Flow cytometric analysis of nuclear DNA content in advanced gastric cancer and its relationship with prognosis. Cancer 67: 2588–2593
Kimura H, Yonemura Y, Epstein AL (1991) Flow cytometric quantitation of the proliferation-associated nuclear antigen p105 and DNA content in advanced gastric cancers. Cancer 68: 2175–2180
Klöppel G, Rindi G, Anlauf M, Perren A, Komminoth P (2007) Site-specific biology and pathology of gastroenteropancreatic neuroendocrine tumors. Virchows Arch 451[Suppl 1]: S9–27
Korenaga D, Okamura T, Saito A et al. (1988) DNA ploidy is closely linked to tumor invasion, lymph node metastasis, prognosis in clinical gastric cancer. Cancer 62: 309–313
Lao CD, Simmons M, Syngal S et al. (2004) Dysplasia in Barrett esophagus. Cancer 100: 1622–1627
Lauren P (1965) The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 64: 31–49
Lazarus C, Jaskiewicz K, Sumeruk RA et al. (1992) Brush cytology technique in the detection of oesophageal carcinoma in the asymptomatic, high risk subject; a pilot survey. Cytopathology 3: 291–296
Lee RG (1987) Villous regeneration in ulcerative colitis. Arch Pathol Lab Med 111: 276–278
Leoni-Parvex S, Mihaescu A, Pellanda A et al. (2000) Esophageal cytology in the follow-up of patients with treated upper aerodigestive tract malignancies. Cancer 90: 10–16
Lewin KJ, Riddel RH, Weinstein WM (1992) Gastrointestinal pathology and its clinical implications. Igaku-Shoin, New York Tokyo
Lux G, Heyder N, Lutz H et al. (1982) Endoscopic ultrasonography--technique, orientation and diagnostic possibilities. Endoscopy 14: 220–225
Marbet UA, Dalquen P, Stalder GA et al. (1985) Wertigkeit von Biopsie und gezielter Bürstenzytologie bei der gastrointestinalen Karzinomdiagnostik aufgrund der Endoskopien von 1979–1984 Schweiz Med Wochenschr 115:1007–1009
Melato M (1997) Gastric cancer and flow cytometry: the beginning of a promising match. Anticancer Res 17: 2279–2284
Melville DM, Richman PI, Shepherd NA et al. (1988) Brush cytology of the colon and rectum in ulcerative colitis: an aid to cancer diagnosis. J Clin Pathol 41: 1180–1186
Montgomery E, Bronner MP, Goldblum JR et al. (2001) Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. Hum Pathol 32: 368–378
Moons LM, Bax DA, Kuipers EJ et al. (2004) The homeodomain protein CDX2 is an early marker of Barrett’s oesophagus. J Clin Pathol 57: 1063–1068
Mortensen NJ, Eltringham WK, Mountford RA et al. (1984) Direct vision brush cytology with colonoscopy: an aid to the accurate diagnosis of colonic strictures. Br J Surg 71: 930–932
Noffsinger AE (2009) Serrated polyps and colorectal cancer: new pathway to malignancy. Annu Rev Pathol 4: 343–364
O’Morchoe PJ, Lee DC, Kozak CA (1983) Esophageal cytology in patients receiving cytotoxic drug therapy. Acta Cytol 27: 630–634
Ohyama S, Yonemura Y, Miyazaki I (1990) Prognostic value of S-phase fraction and DNA ploidy studied with in vivo administration of bromodeoxyuridine on human gastric cancers. Cancer 65: 116–121
Peng HQ, Greenwald BD, Tavora FR et al. (2008) Evaluation of performance of EUS-FNA in preoperative lymph node staging of cancers of esophagus, lung, pancreas. Diagn Cytopathol 36: 290–296
Pinto MM, Levine RH, Shaw-Stiffel T (1993) Detection of Helicobacter pylori by Papanicolaou-stained touch imprint: a comparison with histologic examination. Am J Gastroenterol 88: 1300–1301
Plesec TP, Hunt JL (2009) KRAS mutation testing in colorectal cancer. Adv Anat Pathol 16: 196–203
Post PN, Siersema PD, Van Dekken H (2007) Rising incidence of clinically evident Barrett‘s oesophagus in The Netherlands: a nation-wide registry of pathology reports. Scand J Gastroenterol 42: 17–22
Ribeiro A, Vazquez-Sequeiros E, Wiersema LM et al. (2001) EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma. Gastrointest Endosc 53: 485–491
Riedel F, Goessler UR, Hormann K (2005) Alcohol-related diseases of the mouth and throat. Dig Dis 23: 195–203
Robey SS, Hamilton SR, Gupta PK et al. (1988) Diagnostic value of cytopathology in Barrett esophagus and associated carcinoma. Am J Clin Pathol 89: 493–498
Rodriguez FJ, Abraham SC, Allen MS et al. (2004) Fineneedle aspiration cytology findings from a case of pancreatic heterotopia at the gastroesophageal junction. Diagn Cytopathol 31: 175–179
Rosman AS, Federman Q, Feinman L (1994) Diagnosis of colon cancer by lavage cytology with an orally administered balanced electrolyte solution. Am J Gastroenterol 89: 51–56
Roth MJ, Liu SF, Dawsey SM et al. (1997) Cytologic detection of esophageal squamous cell carcinoma and precursor lesions using balloon and sponge samplers in asymptomatic adults in Linxian, China. Cancer 80: 2047–2059
Rygiel AM, van Baal JW, Milano F et al. (2007) Efficient automated assessment of genetic abnormalities detected by fluorescence in situ hybridization on brush cytology in a Barrett esophagus surveillance population. Cancer 109: 1980–1988
Saad RS, Mahood LK, Clary KM et al. (2003) Role of cytology in the diagnosis of Barrett‘s esophagus and associated neoplasia. Diagn Cytopathol 29: 130–135
Sapi Z, Papp I, Bodo M (1992) Malignant fibrous histiocytoma of the esophagus. Report of a case with cytologic, immunohistologic and ultrastructural studies. Acta Cytol 36: 121–125
Sasaki K, Takahashi M, Hashimoto T et al. (1989) Flow cytometric DNA measurement of gastric cancers. Clinicopathological implication of DNA ploidy. Pathol Res Pract 184: 561–566
Schüler G, Bopp M (1997) Atlas der Krebsmortalität in der Schweiz 1990–1997, Band A. Birjhäuser, Basel, S 55–93
Sciubba JJ (1999) Improving detection of precancerous and cancerous oral lesions. Computer-assisted analysis of the oral brush biopsy. U.S. Collaborative OralCDx Study Group. J Am Dent Assoc 130: 1445–1457
Shekitka KM, Helwig EB (1991) Deceptive bizarre stromal cells in polyps and ulcers of the gastrointestinal tract. Cancer 67: 2111–2117
Shen O, Liu SF, Dawsey SM et al. (1993) Cytologic screening for esophageal cancer: results from 12,877 subjects from a high-risk population in China. Int J Cancer 54: 185–188
Sherman ME, Friedman HB, Busseniers AE et al. (1995) Cytologic diagnosis of anal intraepithelial neoplasia using smears and cytyc thin-preps. Mod Pathol 8: 270–274
Shi J (2007) Defensins and Paneth cells in inflammatory bowel disease. Inflamm Bowel Dis 13: 1284–1292
Shi XY, Bhagwandeen B, Leong AS (2008) CDX2 and villin are useful markers of intestinal metaplasia in the diagnosis of Barrett esophagus. Am J Clin Pathol 129: 571–577
Shu YJ (1983) Cytopathology of the esophagus An overview of esophageal cytopathology in China. Acta Cytol 27: 7–16
Siewert JR (2007) [Esophageal carcinoma]. Chirurg 78: 475–484; quiz 485
Stelow EB, Bardales RH, Stanley MW (2005) Pitfalls in endoscopic ultrasound-guided fine-needle aspiration and how to avoid them. Adv Anat Pathol 12: 62–73
Syrjanen KJ (2002) HPV infections and oesophageal cancer. J Clin Pathol 55: 721–728
Thomas RM, Sobin LH (1995) Gastrointestinal cancer. Cancer 75: 154–1570
Tidbury PJ, Tate JJ, Herbert A (1990) Cytology of colorectal adenomas. Cytopathology 1: 73–78
Tsang TK, Hidvegi D, Horth K et al. (1987) Reliability of balloon-mesh cytology in detecting esophageal carcinoma in a population of US veterans. Cancer 59: 556–559
Varadarajulu S, Eloubeidi MA (2004) Frequency and significance of acute intracystic hemorrhage during EUS-FNA of cystic lesions of the pancreas. Gastrointest Endosc 60: 631–635
Walts AE, Thomas P, Bose S (2005) Anal cytology: is there a role for reflex HPV DNA testing?. Diagn Cytopathol 33: 152–156
Wang HH, Doria MI Jr, Purohit-Buch S et al. (1992) Barrett’s esophagus. The cytology of dysplasia in comparison to benign and malignant lesions. Acta Cytol 36: 60–64
Warnakulasuriya S, Reibel J, Bouquot J et al. (2008) Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement. J Oral Pathol Med 37: 127–133
Weinreb M, Zajicek G, Levij IS (1984) Discrimination between normal and malignant gastric epithelial cells by computer image analysis. Anal Quant Cytol 6: 206–2010
Williams GT, Blackshaw AJ, Morson BC (1979) Squamous carcinoma of the colorectum and its genesis J Pathol 129: 139–147
Wittmann J, Kocjan G, Sgouros SN et al. (2006) Endoscopic ultrasound-guided tissue sampling by combined fine needle aspiration and trucut needle biopsy: a prospective study. Cytopathology 17: 27–33
Yu GH, Nayar R, Furth EE (2001) Adenocarcinoma in colonic brushing cytology: High-grade dysplasia as a diagnostic pitfall. Diagn Cytopathol 24: 364–368
Zargar SA, Khuroo MS, Mahajan R et al. (1991) Endoscopic fine needle aspiration cytology in the diagnosis of gastro-oesophageal and colorectal malignancies. Gut 32: 745–748
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Bubendorf, L., Feichter, G., Obermann, E., Dalquen, P. (2011). Magen-Darm-Trakt. In: Klöppel, G., Kreipe, H., Remmele, W. (eds) Pathologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-04562-2_16
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