New magnifying endoscopic classification for superficial esophageal squamous cell carcinoma

World J Gastroenterol. 2017 Jun 28;23(24):4416-4421. doi: 10.3748/wjg.v23.i24.4416.

Abstract

Aim: To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC).

Methods: This study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed.

Results: Overall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95).

Conclusion: The recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.

Keywords: Esophageal cancer; Magnifying endoscopy; Narrow-band imaging; Squamous cell carcinoma.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / classification*
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Endoscopic Mucosal Resection
  • Esophageal Mucosa / diagnostic imaging*
  • Esophageal Mucosa / pathology
  • Esophageal Neoplasms / classification*
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Esophageal Squamous Cell Carcinoma
  • Esophagectomy
  • Esophagoscopy / methods*
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Narrow Band Imaging / methods
  • Neoplasm Invasiveness / diagnostic imaging
  • Retrospective Studies
  • Sensitivity and Specificity