Esophageal cytology in the follow-up of patients with treated upper aerodigestive tract malignancies

Abstract

BACKGROUND Patients with an history of carcinoma of the upper aerodigestive tract are at high risk for recurrence or the development of new tumors in this region. In the majority of follow‐up protocols, these patients undergo radiologic and endoscopic evaluation as a means of surveillance for the early detection of recurrence. The brush biopsy‐capsule technique represents a noninvasive and inexpensive screening device for this patient population. In the current study, the authors retrospectively assessed the sensitivity, specificity, and predictive value of esophageal brush‐capsule cytology for the detection of malignant lesions of the upper aerodigestive tract in this high risk patient population. METHODS Cytologic specimens from 334 patients with previously treated upper aerodigestive malignancies were available for review. The cytologic, endoscopic, and clinical follow‐up of each case were studied over a follow‐up period of 3 years. Gold standard was the clinical follow‐up for the negative cases (who were not submitted to biopsy) and biopsy for the positive cases. Sensitivity, specificity, and predictive value were calculated. RESULTS Using cytology 33 malignancies were detected in 25 patients during a 3‐year follow‐up period. The test was found to have a sensitivity of 88.7% and a specificity of 90.7%. In 66% of cases the malignancies were located in the oropharynx; the others were located in the esophagus. In 70% of cases the malignancies were detected at an early stage. CONCLUSIONS Esophageal brush‐capsule cytology is a simple noninvasive technique that has been proven to be useful in the early detection of metachronous and recurrent neoplasms in the follow‐up of patients with previously treated carcinomas of the ear, nose, and throat. Cancer (Cancer Cytopathol) 2000;90:10–6. © 2000 American Cancer Society.

Früherkennung von Kopf-Hals-Tumoren

“…Durch die SBC lässt sich der Anteil "inadäquater Proben" deutlich reduzieren. Die SBC läßt sich auf alle Tumoren des Kopf-Hals-Bereiches anwenden; Ösophagus und Hypopharynx, die einem gezielten Abstrich schwer zugänglich sind, kön-nen kursorisch mit einem schluckbaren Schwämmchen erfasst werden [222].…”

Cytology vs molecular analysis for the detection of head and neck squamous cell carcinoma in oesopharyngeal brush samples: a prospective study in 56 patients

“…All patients underwent OPB sampling before panendoscopy with oesophagoscopy, which excluded a second oesophageal tumour. Oesopharyngeal brush sampling was performed, as previously described (Leoni-Parvex et al, 2000). An abrasive sponge wrapped in a capsule (Oesotest s , Biodessa, France) was first swallowed and then withdrawn with a string.…”

“…This definition of positivity was based on oeosophageal cytological criteria proposed by Shu (1983) and used by others (Leoni-Parvex et al, 2000). The cytological evaluation was considered negative only when there was no significant cytonuclear atypia in squamous cells and if the majority of cells were of the intermediate type.…”

“…Cytological screening (Ogden, 1997) has been developed by collecting saliva with or without an oral mucosal brush. Recently, an encapsulated oesopharyngeal brush (OPB) technique for cytological analysis was developed to detect recurrent and metachronous oesophageal carcinomas (Leoni-Parvex et al, 2000). Oesopharyngeal brush has also been shown to be capable of collecting exfoliated cells from oral or pharyngeal carcinoma.…”

Molecular Detection of Early-Stage Laryngopharyngeal Squamous Cell Carcinomas

“…Examination of exfoliated cells has never achieved the same success in the diagnosis of HNSCC as it has in the diagnosis of cancer of the uterine cervix (5). However, an encapsulated pharyngoesophageal brush (PEB) technique (Oesotest) for cytologic analysis was recently developed to detect esophageal carcinomas (6). This technique has been reported to have a sensitivity of 88.7% and a specificity of 90.7% in the detection of recurrent and metachronous neoplasms of the upper aerodigestive tract and seems to be safe and minimally invasive (6).…”