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Pilot study of cytological testing for oesophageal squamous cell dysplasia in a high-risk area in Northern Iran.


ABSTRACT:

Background

Oesophageal squamous cell carcinoma (ESCC) is a fatal disease with 5-year survival rates of <5% in Northern Iran. Oesophageal squamous dysplasia (ESD) is the precursor histologic lesion of ESCC. This pilot study was conducted to assess the feasibility, safety, and acceptability of non-endoscopic cytological examination of the oesophagus and to provide initial data on the accuracy of cytological atypia for identifying patients with ESD in this very-high-risk area.

Methods

Randomly selected asymptomatic participants of the Golestan Cohort Study were recruited. A cytological specimen was taken using a capsule sponge device and evaluated for atypical cells. Sections of the cytological specimen were also stained for p53 protein. Patient acceptability was assessed using a visual analogue scale. The cytological diagnosis was compared with a chromoendoscopic examination using Lugol's solution.

Results

Three hundred and forty-four subjects (43% male, mean (s.d.) age 55.6 (7.9) years) were referred to the study clinic. Three hundred and twelve met eligibility criteria and consented, of which 301 subjects (96.5%) completed both cytological and endoscopic examinations. There were no complications. Most of the participants (279; 92.7%) were satisfied with the examination. The sensitivity and specificity of the cytological examination for identifying subjects with high-grade ESD were 100 and 97%, respectively. We found an accuracy of 100% (95% CI=99-100%) for a combination of cytological examination and p53 staining to detect high-grade ESD.

Conclusions

The capsule sponge methodology seems to be a feasible, safe, and acceptable method for diagnosing precancerous lesions of the oesophagus in this population, with promising initial accuracy data for the detection of high-grade ESD.

SUBMITTER: Roshandel G 

PROVIDER: S-EPMC4264437 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Pilot study of cytological testing for oesophageal squamous cell dysplasia in a high-risk area in Northern Iran.

Roshandel G G   Merat S S   Sotoudeh M M   Khoshnia M M   Poustchi H H   Lao-Sirieix P P   Malhotra S S   O'Donovan M M   Etemadi A A   Nickmanesh A A   Pourshams A A   Norouzi A A   Debiram I I   Semnani S S   Abnet C C CC   Dawsey S M SM   Fitzgerald R C RC   Malekzadeh R R  

British journal of cancer 20140923 12


<h4>Background</h4>Oesophageal squamous cell carcinoma (ESCC) is a fatal disease with 5-year survival rates of <5% in Northern Iran. Oesophageal squamous dysplasia (ESD) is the precursor histologic lesion of ESCC. This pilot study was conducted to assess the feasibility, safety, and acceptability of non-endoscopic cytological examination of the oesophagus and to provide initial data on the accuracy of cytological atypia for identifying patients with ESD in this very-high-risk area.<h4>Methods</h  ...[more]

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