Evaluation of esophageal dysplasia by cytofluorometric analysis

Abstract

In order to grade objectively and characterize dysplastic and precancerous esophageal epithelium its DNA content was measured by cytofluorometric methods and compared to normal and cancerous esophageal epithelium. This yielded the following results. With transition of the esophageal epithelium from mild dysplasia to severe dysplasia and finally to in situ carcinoma, Feulgen-DNA values showed patterns characteristic of a tetraploid population. They lacked prominent peaks which were usually observed with invasive carcinomas. Dominant near-tetraploid population and definite tetraploid-octoploid populations were characteristic of severe dysplasia or carcinoma. The mean Feulgen-DNA values were significantly larger in severe dysplasia than in the lesser grade of dysplasia as well as the normal epithelium. However, this was not the rule in the full blown carcinomas. It would appear that the esophageal cytophotometric patterns are analogous to those previously observed in the skin and uterine cervix.

Epithelial Dysplasia in Cancerous and Noncancerous Esophagi

“…Cytologic follow-up data from China (1975) indicated that 21 (26.6%) among 79 persons with cytologically severe dysplasia progressed to carcinoma and 26 (32.9%) remained more or less severe dysplasia. In our recent study on nuclear DNA con tent in squamous cells of the esophagus, histogram of moderate and severe dysplasia showed an intermediate pattern (Mukada et al 1978) between normal and that of carcinoma. These results disclosed a biological nature of dysplasia as a possible forerunner of carcinoma.…”

Dysplasia and carcinoma in situ of the exocrine pancreas.

“…In other words, they may show chronologically gradual transition toward distinct carcinoma as an extreme. This may be interpreted as a common feature of the preneoplastic lesions of the esophagus (Mukada et al 1978). In the pancreas, after the dysplastic lesion has reached its full development up to carcinoma (in situ), and has once gained aggressive nature, its atypical offsprings, papillary or nonpapillary, may develop into flank invasive pancreatic carcinoma, though the carcinoma may be occult at times (Figs.…”

“…To discuss these problems, the concept "dysplasia" may be helpful. We know some precancerous lesions in the human body as well exemplified by adenoma of the gastrointestinal tract, and dysplasia of the cervix and the esophagus (Mukada et al 1978). But the pancreas is quite different from these organs in that materials for morphological study must be collected during surgery often for advanced carcinoma, or from autopsy cases.…”

“…Therefore, it is well worth elucidating neoplastic and preneoplastic lesions of the pancreas from both pathological and clinical standpoints. The concept of `dysplasia' seems to represent well premalignant lesions particularly of epithelial origin, and therefore is widely acceptable (Robbins and Angell 1971;Mukada et al 1978). In order to clarify the dysplasia and related changes of the exocrine pancreas including Vater's papilla and adjacent duodenal mucosa, and the distal common bile duct, systematized histopathological examination of autopsy materials was carried out.…”

Histological and biological characteristics of esophageal dysplasia

“…Esophageal dysplasia is frequently encountered in squamous cell carcinoma of the esophagus [1], and previous studies have suggested the significance of dysplasia as a precancerous lesion [2][3][4][5]. In a study, epithelial squamous dysplasias of the esophageal mucosa and subclinical carcinoma, respectively, were found in 67 (26.7%) and 6 (2.4%) of 251 autopsied cases of nonesophageal carcinoma [6], suggesting that epithelial squamous dysplasia could be a site of cancer development origin.…”