Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Department of Regeneration and Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Esophagus. 2021 Jan;18(1):118-124. doi: 10.1007/s10388-020-00749-2. Epub 2020 May 23.
Linked color imaging (LCI) improved the visibility of gastric cancer and colorectal flat lesions. This study aimed to investigate the usefulness of LCI in detecting superficial esophageal squamous cell carcinomas (SESCC).
We enrolled 37 consecutive SESCC patients (46 SESCCs) diagnosed using LCI and blue laser imaging bright mode (BLI-BRT) and treated in Hiroshima University Hospital between April 2018 and November 2018. Eight professional endoscopists compared images obtained on non-magnifying BLI-BRT and LCI versus conventional white light imaging (WLI). Identification and boundary diagnosis of SESCC with LCI and BLI-BRT were compared with WLI. Changes in lesion visibility were clarified. Interobserver agreement was assessed. Clinicopathological features of lesion that influence visibility with LCI were assessed.
In LCI, 37% (17/46) of cases had improved visibility and 63% (29/46) had unchanged visibility (interobserver agreement = 0.74). Among cases with multiple lugol voiding lesions (LVLs), ΔE between the lesion and background mucosa was significantly higher in LCI than in WLI (20.8 ± 7.9 vs 9.2 ± 6.1, P < 0.05). No significant differences were found in tumor size, morphological type, color, depth, and smoking or drinking history. However, multiple LVLs were significantly higher among cases with improved versus unchanged visibility. On BLI-BRT, 39% (18/46) of cases had improved visibility and 61% (28/46) had unchanged visibility (interobserver agreement = 0.60).
Almost the same as BLI-BRT, LCI improves SESCC visibility compared with WLI. This is useful for cases with multiple LVLs. In cases without background coloration (BGC), LCI may make SESCC more visible than BLI-BRT.
联合显色成像（LCI）提高了胃癌和结直肠扁平病变的可视性。本研究旨在探讨 LCI 在检测食管浅表鳞状细胞癌（SESCC）中的作用。
我们纳入了 2018 年 4 月至 2018 年 11 月在广岛大学医院接受 LCI 和蓝激光成像亮模式（BLI-BRT）诊断和治疗的 37 例连续 SESCC 患者（46 个 SESCC）。8 名专业内镜医生对比非放大 BLI-BRT 和 LCI 与常规白光成像（WLI）获得的图像。比较 LCI 和 BLI-BRT 对 SESCC 的识别和边界诊断与 WLI 的结果。明确病变可视性的变化。评估观察者间的一致性。评估影响 LCI 下病变可视性的病变临床病理特征。
在 LCI 中，46 个 SESCC 中有 37%（17/46）的病变可视性得到改善，63%（29/46）的病变可视性无变化（观察者间一致性=0.74）。在存在多个卢戈氏染色空泡（LVLs）的病变中，病变与背景黏膜之间的ΔE 在 LCI 中显著高于 WLI（20.8±7.9 比 9.2±6.1，P<0.05）。肿瘤大小、形态类型、颜色、深度以及吸烟或饮酒史无显著差异。然而，在可视性改善的病变中，多个 LVLs 明显高于可视性无变化的病变。在 BLI-BRT 中，46 个 SESCC 中有 39%（18/46）的病变可视性得到改善，61%（28/46）的病变可视性无变化（观察者间一致性=0.60）。
与 BLI-BRT 相似，LCI 提高了 SESCC 与 WLI 相比的可视性。这对于存在多个 LVLs 的病例很有用。在无背景着色（BGC）的情况下，LCI 可能使 SESCC 比 BLI-BRT 更明显。
