Résumé
La chromoscopie fait un large deage de produits de contraste destinés à accentuer le relief superficiel (coloration de contrasle) et/ou identifier un épithélium spécifique par coloration vitale (coloration par absorption) ou par réactions chimiques (coloraion réactive). Aussi bien les colorations par contraste que les colorations par absorption connaissent les applications potentielles chez les patients porteurs d’un œsophage de Barrett. L’accentuation des détails de la surface muqueuse de l’œsophage de Barrett par coloration de contraste permet d’iddentifier des zones de muqueuse métaplasique non reconnues par l’endoscopie de routine ou des imperfections de la surface au niveau de zones néoplasiques qui avaient échappé à la vidéoendoscopie standard. De même, les colorations vitales permettent d’identifier des épithéliums spécifiques, c’est-à-dire la métaplasie intestinale ou la dysplasie qui sont associées au processus carcinologique de l’óesophage de Barrett, ou au contraire identifier des zones non colorées corrspondant à un stade précoce de la malignité. Malheureusement, on dispose de peu de données concernant la chromoendoscopie dans l’œsophage de Barrett et des études ultérieures sont amplement justifiées.
Summary
Chromoscopy broadly refers to the use of contrast agents toaccentuate surface topography (contrast staining), and/or identify specific epithelia by vital staining (absorptive staining) or chemical reactions (reactive staining). Both contrast staining and asborptive staining techniques have potential applictions in patients with Barrett’s esophagus. Accentuating the detail of the surface topography of Barrett’s esophagus with contrast staining may allow for identification of areas of Barrett’s esophagus not appreciated during routine endoscopy or surface imperfections in areas of neoplasia that were missed by standard video endoscopic pxamination. Similarly vital staining could be used to identify specific epithelia i.e. intestinal metaplasia or dysplasia that are associated with the carcinogenic pathway in Barrett’s esophagus, or conversely identifying areas unstained that may represent early malignancy. Unfortunately there is little data regarding use of chromoendoscopy in Barrett’s esophagus and further work in this field is justified.
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Fennerty, M.B. La chromoscople dans le diagnostic et la surveillance de l’œsophage de Barrett. Acta Endosc 31, 151–159 (2001). https://doi.org/10.1007/BF03023602
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DOI: https://doi.org/10.1007/BF03023602
Mots-clés
- adénocarcinome
- biopsie ciblée
- chromoscopie
- dépistage
- diagnostic précoce
- dysplasie
- œsophage
- œsophage de Barrett
- surveillance
- vidéoendoscopie