Hatta Waku, Koike Tomoyuki, Ogata Yohei, Kondo Yutaka, Ara Nobuyuki, Uno Kaname, Asano Naoki, Imatani Akira, Masamune Atsushi
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Division of Gastroenterology, Tohoku Rosai Hospital, 4-3-21 Dainohara, Aoba-ku, Sendai 981-8563, Japan.
Diagnostics (Basel). 2021 Oct 20;11(11):1941. doi: 10.3390/diagnostics11111941.
Blue light imaging (BLI) and narrow-band imaging (NBI) are two modalities that enable narrow-band light observation. We aimed to compare the diagnostic ability of magnifying endoscopy with BLI (ME-BLI) and NBI (ME-NBI) for determining the invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by the Japanese Esophageal Society's intrapapillary capillary loop (IPCL) classification. We enrolled 81 patients between 2014 and 2018, and the still endoscopic images for diagnosing the invasion depth at the same part in ME-BLI and ME-NBI were registered. Two blinded investigators reviewed them and diagnosed the invasion depth by the IPCL classification. Subsequently, the diagnostic yields in two modalities were compared. The overall accuracies for the invasion depth by the IPCL classification in ME-BLI and ME-NBI did not differ significantly (67.9-71.6% vs. 72.8-74.1%). In the analysis based on the invasion depth, the sensitivities and positive predictive values in tumors invading the muscularis mucosa or submucosa ≤200 µm were low (23.1-30.8% and 16.7-25.0%, respectively) in both modalities. In conclusion, the diagnostic ability for determining the invasion depth of SESCC by the IPCL classification was relatively similar in ME-BLI and ME-NBI, but diagnosis by magnifying endoscopy alone might not be satisfactory.
蓝光成像(BLI)和窄带成像(NBI)是两种能够进行窄带光观察的模式。我们旨在通过日本食管学会的乳头内毛细血管袢(IPCL)分类,比较放大内镜联合BLI(ME-BLI)和联合NBI(ME-NBI)对浅表性食管鳞状细胞癌(SESCC)浸润深度的诊断能力。我们纳入了2014年至2018年间的81例患者,并记录了ME-BLI和ME-NBI中用于诊断同一部位浸润深度的静态内镜图像。两名盲法研究者对这些图像进行了评估,并通过IPCL分类诊断浸润深度。随后,比较了两种模式的诊断率。ME-BLI和ME-NBI中通过IPCL分类对浸润深度的总体准确率无显著差异(67.9 - 71.6%对72.8 - 74.1%)。在基于浸润深度的分析中,两种模式下浸润至黏膜肌层或黏膜下层≤200 µm的肿瘤的敏感性和阳性预测值均较低(分别为23.1 - 30.8%和16.7 - 25.0%)。总之,ME-BLI和ME-NBI通过IPCL分类对SESCC浸润深度的诊断能力相对相似,但仅通过放大内镜诊断可能并不令人满意。