窄带成像放大内镜对浅表性食管鳞状细胞癌患者浸润深度诊断准确性的回顾性评估
Retrospective Assessment of the Diagnostic Accuracy of the Depth of Invasion by Narrow Band Imaging Magnifying Endoscopy in Patients with Superficial Esophageal Squamous Cell Carcinoma.
作者信息
Katada Chikatoshi, Tanabe Satoshi, Wada Takuya, Ishido Kenji, Yano Takafumi, Furue Yasuaki, Kondo Yuki, Kawanishi Natsuko, Yamane Sakiko, Watanabe Akinori, Azuma Mizutomo, Koizumi Wasaburo
机构信息
Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
Department of Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
出版信息
J Gastrointest Cancer. 2019 Jun;50(2):292-297. doi: 10.1007/s12029-018-0075-6.
PURPOSE
Treatment strategies for superficial esophageal squamous cell carcinoma (S-ESCC) are determined mainly on the basis of the depth of invasion. We retrospectively studied the accuracy of the depth of tumor invasion, comprehensively assessed using the Japan Esophageal Society (JES) classification.
METHODS
The study group comprised 256 patients who underwent narrow band imaging (NBI) magnifying endoscopy, and endoscopic submucosal dissection for S-ESCC. The depth of invasion of S-ESCC was classified into three groups: EP/LPM, MM/SM1, and SM2. The following variables were studied retrospectively: (1) the diagnostic accuracy of non-magnifying white-light endoscopy, (2) the diagnostic accuracy of type B vessels, (3) the diagnostic accuracy of avascular area (AVA), (4) the diagnostic accuracy of the JES classification, and (5) the diagnostic accuracy of comprehensive diagnosis. The depth of invasion was assessed by white-light non-magnifying endoscopy, followed by NBI magnifying endoscopy.
RESULTS
The positive predictive value (PPV) of white-light non-magnifying endoscopy was 86% for EP/LPM, 53% MM/SM1, and 74% for SM2. The PPV of the diagnosis of type B vessels was 93% for EP/LPM, 62% for MM/SM1, and 74% for SM2. The PPV of the AVA diagnosis was 73% for EP/LPM, 89% for MM/SM1, and 100% for SM2. The PPV of diagnosis according to the JES classification was 93% for EP/LPM, 65% for MM/SM1, and 77% for SM2. The PPV of the comprehensive diagnosis was 94% for EP/LPM, 63%, for MM/SM1, and 75% for SM2.
CONCLUSIONS
The additional use of NBI magnifying endoscopy can enhance the diagnostic accuracy of the depth of invasion in patients with S-ESCC.
目的
浅表性食管鳞状细胞癌（S-ESCC）的治疗策略主要根据浸润深度来确定。我们回顾性研究了使用日本食管学会（JES）分类法综合评估的肿瘤浸润深度的准确性。
方法
研究组包括256例行窄带成像（NBI）放大内镜检查及S-ESCC内镜黏膜下剥离术的患者。S-ESCC的浸润深度分为三组：上皮内癌/黏膜下层浅层（EP/LPM）、黏膜肌层/黏膜下层深层1（MM/SM1）和黏膜下层深层2（SM2）。回顾性研究以下变量：（1）非放大白光内镜的诊断准确性，（2）B型血管的诊断准确性，（3）无血管区（AVA）的诊断准确性，（4）JES分类的诊断准确性，以及（5）综合诊断的诊断准确性。浸润深度通过白光非放大内镜评估，随后进行NBI放大内镜评估。
结果
白光非放大内镜对EP/LPM的阳性预测值（PPV）为86%，对MM/SM1为53%，对SM2为74%。B型血管诊断的PPV对EP/LPM为93%，对MM/SM1为62%，对SM2为74%。AVA诊断的PPV对EP/LPM为73%，对MM/SM1为89%，对SM2为100%。根据JES分类诊断的PPV对EP/LPM为93%，对MM/SM1为65%，对SM2为77%。综合诊断的PPV对EP/LPM为94%，对MM/SM1为63%，对SM2为75%。
结论
额外使用NBI放大内镜可提高S-ESCC患者浸润深度的诊断准确性。
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