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浅表性食管鳞状细胞癌的新型放大内镜分类

New magnifying endoscopic classification for superficial esophageal squamous cell carcinoma.

作者信息

Kim Su Jin, Kim Gwang Ha, Lee Moon Won, Jeon Hye Kyung, Baek Dong Hoon, Lee Bong Eun, Song Geun Am

机构信息

Su Jin Kim, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea.

出版信息

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.

摘要

目的

评估一种新的放大内镜(ME)分类法预测浅表性食管鳞状细胞癌(SESCC)浸润深度的准确性。

方法

本研究纳入了2010年8月至2016年7月期间69例接受切除术前窄带成像放大内镜(ME-NBI)检查的SESCC患者,共70个病变。采用日本食管学会(JES)提出的新ME分类法分析ME-NBI预测SESCC浸润深度的准确性,并评估观察者间的一致性。

结果

ME-NBI评估SESCC浸润深度的总体准确率为78.6%。对于局限于上皮层(m1)或侵犯固有层(m2)的肿瘤,B1型的敏感性和特异性分别为71.4%和100%。对于侵犯黏膜肌层(m3)或浅表黏膜下层(≤200μm,sm1)的肿瘤,B2型的敏感性和特异性分别为94.4%和73.1%,而对于侵犯深层黏膜下层(>200μm,sm2)的肿瘤,B3型的敏感性和特异性分别为75.0%和97.8%。观察者间的一致性良好(κ=0.86,95%CI:0.76-0.95)。

结论

最近开发的JES ME分类法有助于预测SESCC的浸润深度,观察者间的一致性可靠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d415/5487505/2de9cf4b9325/WJG-23-4416-g001.jpg

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