Magnifying endoscopy with narrow band imaging for predicting the invasion depth of superficial esophageal squamous cell carcinoma

Abstract

The invasion depth of superficial esophageal squamous cell carcinoma is important in determining therapeutic strategy. The aim of this study was to prospectively investigate the clinical utility of magnifying endoscopy with narrow band imaging compared with that of non-magnifying high-resolution endoscopy or high-frequency endoscopic ultrasonography in predicting the depth of superficial esophageal squamous cell carcinoma. The techniques were carried out in 72 patients with 101 superficial esophageal squamous cell carcinomas, which were then resected by either endoscopic mucosal resection or esophagectomy. The histological invasion depth was divided into two: mucosal or submucosal carcinoma. We investigated the relationship between endoscopic staging and histology of tumor depth. Non-magnifying high-resolution endoscopy, magnifying endoscopy with narrow band imaging, and high-frequency endoscopic ultrasonography had overestimation/underestimation rates of 7/5, 4/4 and 8/3%, respectively. The sensitivity rates for the three techniques were 72, 78, and 83%, respectively, and the specificity rates were 92, 95, and 89%, respectively. There were no statistically significant differences among the three endoscopic techniques. Clinical utility of magnifying endoscopy with narrow band imaging does not seem to be significantly different from that of non-magnifying high-resolution endoscopy or high-frequency endoscopic ultrasonography in predicting the depth of superficial esophageal squamous cell carcinoma. Magnifying endoscopy with narrow band imaging may have potential to reduce overestimation risks of non-magnifying high-resolution endoscopy or high-frequency endoscopic ultrasonography.

High-Resolution ENT Video Endoscope with Superior Image Quality Equivalent to that of Gastric Video Endoscopes

“…In particular, abnormal IPCLs have been reported as an early finding in esophageal and pharyngeal carcinomas [1][2][3][4]. Magnifying endoscopy coupled with NBI has been reported to be useful for detecting IPCLs [3,4]. With the use of these superior video endoscopes, hypopharyngeal as well as mesopharyngeal carcinomas were detected during diagnostic examinations for esophageal and gastric diseases by gastroenterologists and surgeons [7].…”

“…In particular, abnormal IPCLs have been reported as an early finding in esophageal and pharyngeal carcinomas [1][2][3][4]. Magnifying endoscopy coupled with NBI has been reported to be useful for detecting IPCLs [3,4].…”

“…At present, esophageal cancer can be detected at an early stage by observing characteristic vascular abnormalities such as abnormal Intraepithelial Papillary Capillary Loops (IPCLs) [1][2][3][4]. Pharyngeal carcinoma has been detected in the same manner, and carcinomas of the head and neck can be detected early with the use of video endoscopes in the upper gastrointestinal tract [5][6][7][8].…”

“…Some techniques and devices, including the use of dyes (such as iodine) and NBI, have facilitated detection of carcinoma at an early stage [3][4][5][6][7]. However, these procedures or devices require drug administration or a specialized light source.…”

Fujinon intelligent color enhancement for the diagnosis of early esophageal squamous cell carcinoma and precancerous lesion

“…Then, the suspicious abnormal esophagus would be diagnosed by pathologic diagnosis. The various IPCL changes were classified as follows: dilatation, tortuosity, caliber change, and variety of shapes (13). The IPCL types in this study were based on our personal observation in our unit and from the published literature (13)(14)(15) Type IV (severe dysplasia): no more than three of the four kinds of changes as mentioned above Type V (carcinoma): all of the four changes as mentioned above…”