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Cancer of the esophagus is a disease with a very poor prognosis for survival: five years after diagnosis, between 90 and 96 percent of the patients have died. The only cure for esophageal cancer is surgical removal of the tumor, but this can only be carried out in selected cases. Those cases in which there is infiltration of the esophageal musculature by the tumor are considered to be inoperable, and only palliative treatment (to reduce pain and keep the patient comfortable) is administered. The remainder of the cases should undergo surgical treatment as soon as possible. To avoid unnecessary surgery, accurate determination of the degree of tumor infiltration is necessary. Currently used methods, such as computed tomography (a technique for visualizing internal structures), often fail to correctly diagnose the stage of the cancer. To evaluate the usefulness of endosonography (visualization of the esophagus and stomach by means of a flexible ultrasound probe inserted into the esophagus), a study was carried out with 52 patients suffering from esophageal cancer. Patients underwent both computed tomography and endosonography for diagnosis of their condition. Thirty-seven of these patients had subsequent verification of the degree of esophageal involvement either during surgery or at autopsy. Endosonography correctly identified the stage of the cancer in 89 percent of the patients with early-stage cancer and 69 percent with late-stage, compared with 51 percent for both types when evaluated with computed tomography. These significant improvements in accuracy with endosonography show that it is a useful tool in the diagnosis and evaluation of esophageal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

A. Leodolter [1] K. Ziegler [3] M. Heep [3] P. Malfertheiner [1] N. Lehn [3] [16/09] Comparison of Different Diagnostic Tests for Detection of H. pylori Infection in General Practice [...]

A. Ledolter [1] K. Ziegler [2] N. Lehn [3] P. Malfertheiner [1] [16/03] The H. pylori Antigen Stool Test for Determination of H. pylori Status in General Practice: Is Unfrozen [...]

When there is villus atrophy in a jejunal biopsy, intraepithelial lymphocyte (IEL) mitosis correlates with a diagnosis of coeliac disease. We have examined the significance of IEL mitosis in jejunal biopsies with normal villi. Counts of IEL per 100 villus enterocytes, and IEL mitosis per 1000 IEL, were carried out in 81 jejunal biopsies. Thirty one were from patients with coeliac disease or dermatitis herpetiformis, and many of these, from treated patients, were histologically normal; 40 were from patients with other diagnoses, selected to include biopsies with a high IEL count (greater than 40 IEL per 100 enterocytes) but normal villi. Three coeliacs and 10 dermatitis herpetiformis patients had an IEL count of less than 40, and no IEL mitoses were found in these biopsies. Two dermatitis herpetiformis patients had IEL counts of 43.7% and 43.9%, with no IEL mitoses, but in all other coeliac and dermatitis herpetiformis biopsies high IEL counts were associated with IEL mitotic indices between 0.05% and 1.77%. In the non-coeliac, non-dermatitis herpetiformis group, no IEL mitoses were found in the 22 biopsies with IEL count less than 43%. In the others, IEL counts ranged from 44.8% to 127.0%, and IEL mitoses were present, with mitotic indices ranging from 0.06% to 0.49%. This work shows that IEL mitosis in a jejunal biopsy is not specific for coeliac disease, but occurs whenever there is an increased density of IEL within the villus epithelium. [ABSTRACT FROM PUBLISHER]