Leoni-Parvex S, Mihaescu A, Pellanda A, Monnier P, Bosman F T
Institute of Pathology, Centre Hospitalier Universitaire Vaudois Hospital Lausanne, Switzerland.
Cancer. 2000 Feb 25;90(1):10-6.
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.
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.
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.
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.
上呼吸道消化道癌病史患者在该区域复发或发生新肿瘤的风险很高。在大多数随访方案中，这些患者接受放射学和内镜检查，作为早期发现复发的监测手段。刷检活检胶囊技术是针对这一患者群体的一种非侵入性且廉价的筛查设备。在本研究中，作者回顾性评估了食管刷检胶囊细胞学对上呼吸道消化道癌高危患者群体中恶性病变检测的敏感性、特异性和预测价值。
有334例曾接受过上呼吸道消化道恶性肿瘤治疗的患者的细胞学标本可供回顾。对每例患者进行了为期3年的细胞学、内镜和临床随访研究。阴性病例（未接受活检者）的金标准是临床随访，阳性病例的金标准是活检。计算敏感性、特异性和预测价值。
在3年随访期内，通过细胞学检查在25例患者中检测到33例恶性肿瘤。该检测方法的敏感性为88.7%，特异性为90.7%。66%的恶性肿瘤位于口咽；其他位于食管。70%的恶性肿瘤在早期被检测到。
食管刷检胶囊细胞学是一种简单的非侵入性技术，已被证明在既往有耳鼻咽喉癌患者的随访中，对异时性和复发性肿瘤的早期检测有用。
