Misset J L, Mathé G, Santelli G, Gouveia J, Homasson J P, Sudre M C, Gaget H
Cancer Detect Prev. 1986;9(1-2):167-70.
Forty heavy-smoker (over 15 packets per year) volunteers were selected for and have completed a 6-month etretinate treatment on the basis of an index of metaplasia (IM) greater than 15% determined according to the following procedure: bronchoscopy with systematic biopsies in ten sites of the bronchial tree. Each biopsy was cut into ten sections and an IM was calculated: IM = number of sections with epidermoid metaplasia/number of sections examined X 100. Etretinate, a retinoid derivative, was given orally at the daily dose of 25 mg, at the end of which patients underwent a second fibroscopy protocol. A highly significant reduction of IM (P = 10(-5)) was observed after 6 months of treatment for those of the patients who maintained their smoking habits during treatment. Besides, the four patients who stopped smoking while under treatment and are excluded from the statistical analysis all had a complete regression of metaplasia at the second fibroscopy. No morbidity was due to etretinate or fibroscopy. Etretinate significantly reduces potentially precancerous bronchial epidermoid metaplasia in heavy smokers. Its association with smoking arrest may induce a rapid restoration of bronchial epithelium to normal.
40名重度吸烟者（每年吸烟超过15包）志愿者入选并根据以下程序确定化生指数（IM）大于15%后完成了6个月的依曲替酯治疗：在支气管树的10个部位进行系统性活检的支气管镜检查。每次活检切成10个切片并计算IM：IM = 有鳞状化生的切片数/检查的切片数×100。依曲替酯是一种维甲酸衍生物，每日口服剂量为25mg，治疗结束时患者接受第二次纤维镜检查方案。在治疗期间保持吸烟习惯的患者中，治疗6个月后观察到IM显著降低（P = 10⁻⁵）。此外，4名在治疗期间戒烟且被排除在统计分析之外的患者在第二次纤维镜检查时化生均完全消退。没有发病率是由依曲替酯或纤维镜检查引起的。依曲替酯可显著降低重度吸烟者潜在的癌前支气管鳞状化生。它与戒烟相结合可能会使支气管上皮迅速恢复正常。
