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Dépistage et diagnostic précoce du cancer colorectal

Screening and early diagnosis of colorectal cancer

  • Published:
Acta Endoscopica

Résumé

Qu’est-on en droit d’attendre d’une méthode idéale de dépistage et de surveillance par coloscopie? La technique doit permettre la détection d’importantes lésions mais aussi de discrètes altérations muqueuses. Idéalement, la distinction endoscopique entre lésion néoplasique et non néoplasique devrait être possible en cours d’examen. Actuellement, l’endoscopie peut être réalisée avec de nouveaux endoscopes plus puissants. Parallèlement au développement rapide des puces électroniques, les caractéristiques optiques des nouveaux endoscopes offrent des résolutions qui permettent de voir de nouveaux détails de la surface muqueuse. En complément de la chromo-endoscopie, les nouveaux vidéocoloscopes permettent actuellement une observation plus aisée et plus impressionnante par rapport aux endoscopes à fibres optiques utilisés auparavant.

Récemment, les nouvelles techniques endoscopiques, telles que l’imagerie à bande spectrale étroite (NBI), l’endocystocopie ou l’endoscopie laser confocale, ont permis de découvrir un nouvel univers grâce aux détails des images qui amélioreront sans aucun doute le rendement diagnostique dans le cadre des lésions malignes au début. La présente revue résume les techniques actuellement disponibles et les données cliniques qu’elles fournissent dans le diagnostic des cancers du tractus digestif inférieur au début.

Summary

What should an ideal screening and surveillance colonoscopy be able to accomplish? The technique should allow detection of large but also discrete mucosal alterations. Ideally, endoscopic discrimination between neoplastic and non-neoplastic lesions would be possible during the ongoing procedure. At present, endoscopy can be performed with new powerful endoscopes. Comparably to the rapid development in chip technology, the optic features of the newly designed endoscopes offer resolutions which allow new surface details to be seen. In conjunction with chromoendoscopy, the newly discovered tool video colonoscopy is much easier and more impressive today than with the previously used fiberoptic endoscopes.

Recently, new endoscopic technologies like naarow band imaging, endocytoscopy, or confocal laser endoscopy have allowed for discovering a whole new world of image details, which will surely improve the diagnostic yield in the field of early malignancies. This review summarizes newly available technologies and clinical data about the diagnosis of early lower gastrointestinal cancers.

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  1. Ralf Kiesslich & Markus F. Neurath

    Present address: I. Med. Klinik und Poliklinik, Johannes Gutenberg Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

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    Kiesslich, R., Neurath, M.F. Dépistage et diagnostic précoce du cancer colorectal. Acta Endosc 37, 207–229 (2007). https://doi.org/10.1007/BF02961791

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