Suzuki Yugo, Okamura Takayuki, Matsui Akira, Hayasaka Junnosuke, Nomura Kosuke, Kikuchi Daisuke, Hoteya Shu
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Gastrointest Tumors. 2022 Jun 20;9(2-4):59-68. doi: 10.1159/000525586. eCollection 2022 Dec.
The Japanese guidelines for endoscopic submucosal dissection (ESD) of Barrett's esophageal adenocarcinoma (BEA) recommend image-enhanced magnifying endoscopic examination for diagnosing the lateral extent of superficial esophageal adenocarcinoma. The Japan Esophageal Society Barrett's Esophagus (JES-BE) classification is proposed recently and is useful in terms of diagnostic accuracy. In this study, we retrospectively examined the usefulness of the JES-BE classification for differential diagnosis and determination of the extent of BEA originating in short-segment Barrett's esophagus.
The study reviewed 51 lesions which underwent ESD for BEA. The circumference of the esophagogastric junction was divided into four parts, and the lesions were divided into those in the right anterior portion (RA group; = 33) and those in other portions (non-RA group; = 18). Clinicopathological characteristics and clinical outcomes were compared between the two groups.
JES-BE classification findings as "dysplasia" were seen in 48 out of 51 (94.1%) BEA lesions retrospectively. There was no significant difference in histological type, tumor depth, lymphovascular invasion, or the proportion of tumors with a positive or unknown horizontal or vertical margin status between the groups. The proportion of tumors with type 0-I morphology was significantly higher in the RA group ( = 0.023). The tumor size was significantly greater in the RA group ( = 0.034). According to the JES-BE classification, 31 lesions (93.9%) in the RA group and 17 lesions (94.4%) in the non-RA group were diagnosed as dysplasia. There was also no significant difference in the rate of consistency between the endoscopic and histopathological findings on the lateral extent of the lesion (90.9% vs. 83.3%; = 0.612).
DISCUSSION/CONCLUSIONS: The JES-BE classification may be useful for determining the extent of BEA.
日本巴雷特食管腺癌（BEA）内镜黏膜下剥离术（ESD）指南推荐采用图像增强放大内镜检查来诊断浅表食管腺癌的侧向范围。日本食管学会巴雷特食管（JES - BE）分类法是最近提出的，在诊断准确性方面很有用。在本研究中，我们回顾性研究了JES - BE分类法在鉴别诊断和确定起源于短节段巴雷特食管的BEA范围方面的实用性。
本研究回顾了51例行ESD治疗BEA的病变。将食管胃交界处分四个部分，病变分为右前部病变（RA组；n = 33）和其他部位病变（非RA组；n = 18）。比较两组的临床病理特征和临床结果。
回顾性分析发现，51例BEA病变中有48例（94.1%）的JES - BE分类结果为“发育异常”。两组在组织学类型、肿瘤深度、脉管侵犯或水平或垂直切缘状态为阳性或未知的肿瘤比例方面无显著差异。RA组中0 - I型形态的肿瘤比例显著更高（P = 0.023）。RA组的肿瘤大小显著更大（P = 0.034）。根据JES - BE分类法，RA组31例病变（93.9%）和非RA组17例病变（94.4%）被诊断为发育异常。病变侧向范围的内镜和组织病理学检查结果的一致性率也无显著差异（90.9%对83.3%；P = 0.612）。
讨论/结论：JES - BE分类法可能有助于确定BEA的范围。
