Endoscopy. 2005 Jun;37(6):570-8. doi: 10.1055/s-2005-861352.
Neoplastic lesions in the digestive-tract mucosa are termed "superficial" when the depth of invasion is limited to the mucosa and submucosa. The endoscopic appearance has a predictive value for invasion into the submucosa, which is critical for the risk of nodal metastases.
The endoscopic morphology of superficial lesions can be assessed with a standard video endoscope after spraying of a dye--an iodine-potassium iodide solution for the stratified squamous epithelium, or an indigo carmine solution for the columnar epithelium. In 2002, a workshop was held in Paris to explore the relevance of the Japanese classification. The conclusions were revised in 2003 in Osaka in relation to the definition of the subtypes used in endoscopy and the evaluation of the depth of invasion into the submucosa. In Japan, the description of advanced cancer in the digestive-tract mucosa using types 1 - 4 is supplemented by a type 0 when the endoscopic appearance is that of a superficial lesion. Type 0 is divided into three categories: protruding (0 - I), nonprotruding and nonexcavated (0 - II), and excavated (0 - III). Type 0 - II lesions are then subdivided into slightly elevated (IIa), flat (IIb), or depressed (IIc). Nonprotruding depressed lesions are associated with a higher risk of submucosal invasion. After endoscopic resection, invasion into the submucosa is an important criterion for the necessity of additional surgical resection. Micrometer analysis of the depth of invasion in the specimen is more precise, and distinct cut-off limits have been established in the esophagus, stomach, and large bowel.
The morphology of superficial and nonprotruding neoplastic lesions is relevant to the prognosis. Following endoscopic detection, the lesions are analyzed using chromoendoscopy and assigned a subtype of the type 0 classification. The choice between endoscopic or surgical treatment is based on this description.
当消化道黏膜肿瘤性病变的浸润深度局限于黏膜层和黏膜下层时，称为“表浅性”病变。内镜表现对判断黏膜下层浸润具有预测价值，而黏膜下层浸润对于有无淋巴结转移风险至关重要。
在喷洒染料后，可使用标准视频内镜评估表浅性病变的内镜形态。对于复层鳞状上皮，使用碘-碘化钾溶液；对于柱状上皮，使用靛胭脂溶液。2002年在巴黎举办了一次研讨会，探讨日本分类法的相关性。2003年在大阪根据内镜检查中使用的亚型定义以及对黏膜下层浸润深度的评估对结论进行了修订。在日本，当内镜表现为表浅性病变时，使用1 - 4型描述消化道黏膜进展期癌时补充0型。0型分为三类：隆起型（0 - I）、非隆起无凹陷型（0 - II）和凹陷型（0 - III）。然后将0 - II型病变再细分为微隆起型（IIa）、平坦型（IIb）或凹陷型（IIc）。非隆起凹陷型病变黏膜下层浸润风险较高。内镜切除术后，黏膜下层浸润是决定是否需要追加手术切除的重要标准。对标本浸润深度进行微米分析更为精确，并且在食管、胃和大肠中已确定了不同的临界值。
表浅性和非隆起性肿瘤性病变的形态与预后相关。内镜检查发现病变后，使用色素内镜对病变进行分析并指定为0型分类的一个亚型。内镜治疗或手术治疗的选择基于这一描述。
