Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Esophagus. 2021 Jan;18(1):111-117. doi: 10.1007/s10388-020-00754-5. Epub 2020 Jun 8.
Prediction of the invasive depth is the objective of endoscopic observation for digestive cancer. In superficial esophageal cancer, a close relationship between microvascular patterns observed by magnifying endoscopy with narrow-band imaging (M-NBI) and pathological depth of invasion is well known. The ability of M-NBI to predict the invasion depth in superficial pharyngeal squamous cell carcinoma (SPSCC) has been seldom evaluated. This study aimed to clarify the relationship between the microvasculature patterns and pathological depth in SPSCC.
SPSCC lesions evaluated with M-NBI followed by endoscopic resection were analyzed between April 2010 and March 2017. Endoscopic images were classified as microvasculature tumor types B1, B2, and B3 according to the Japan Esophageal Society classification. The pathological depth of invasion was described as either squamous cell carcinoma in situ (Tis) or invasive subepithelial cancer, and the tumor thickness of all lesions was examined. Data were analyzed using the unpaired t, χ, or Mann-Whitney U test.
Type B1 and type B2/B3 (35/3) microvessels were found in 180 lesions (82%) and 39 (18%), respectively. Of the flat lesions, 115 (83%) were classified as Tis and 23 (17%) as subepithelial cancer. Positive and negative predictive values of the B1 vessels were 77% and 82%, respectively. Additional analysis showed that the positive predictive value of the B1 vessels for the flat-type lesions was 87%; the negative predictive value for the elevated lesions was 93%.
Microvascular patterns observed by M-NBI are an important factor in predicting the pathological depth of invasion.
预测浸润深度是消化系癌症内镜观察的目标。在早期食管癌中，放大内镜窄带成像（M-NBI）观察到的微血管形态与病理浸润深度密切相关。M-NBI 预测早期下咽鳞癌（SPSCC）浸润深度的能力尚未得到充分评估。本研究旨在阐明 SPSCC 微血管形态与病理浸润深度的关系。
回顾性分析 2010 年 4 月至 2017 年 3 月间接受 M-NBI 评估并经内镜切除的 SPSCC 病变。根据日本食管学会分类，将内镜图像分为微血管肿瘤类型 B1、B2 和 B3。病理浸润深度描述为原位鳞状细胞癌（Tis）或黏膜下浸润癌，并检查所有病变的肿瘤厚度。采用独立样本 t 检验、χ2 检验或 Mann-Whitney U 检验进行数据分析。
180 处病变（82%）和 39 处病变（18%）分别发现 B1 型和 B2/B3 型微血管（35/3）。平坦型病变中，115 处（83%）为Tis，23 处（17%）为黏膜下癌。B1 型血管的阳性预测值和阴性预测值分别为 77%和 82%。进一步分析显示，B1 型血管对平坦型病变的阳性预测值为 87%；对隆起型病变的阴性预测值为 93%。
M-NBI 观察到的微血管形态是预测病理浸润深度的重要因素。
