Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.
Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Dig Endosc. 2024 Apr;36(4):421-427. doi: 10.1111/den.14657. Epub 2023 Aug 29.
Prediction of the risk of esophageal squamous cell carcinoma (SCC) by endoscopic findings without iodine staining, which is irritating to the esophagus, would be beneficial. In a previous retrospective study, we found that multiple foci of dilated vascular areas (MDV) of the esophageal mucosa, seen in narrow-band imaging (NBI)/blue laser imaging (BLI), are associated with iodine-unstained lesions and, thus, may be a predictor of esophageal SCC. This prospective study aimed to investigate the association between MDV and metachronous esophageal SCC.
Patients with a history of endoscopic resection for esophageal SCC were included in the study. First, evaluation of the MDV using NBI or BLI was conducted during the initial endoscopy. The patients were then monitored for metachronous esophageal SCC by endoscopic surveillance. The association between the number of MDV and incidence of metachronous esophageal SCC was investigated.
From February 2018 to May 2019, 206 patients were enrolled and 201 patients were included in the analysis. Patients were followed up until October 2022. The median (interquartile range) endoscopic follow-up period was 1260 (1105-1348) days. The incidence of metachronous esophageal SCC at 2 years was 7.1% in patients with MDV ≤4 and 13.9% in patients with MDV ≥5 (P < 0.01). In the multivariate analysis, MDV was an independent predictor of metachronous esophageal SCC, with an odds ratio (95% confidence interval) of 2.37 (1.06-5.31).
Multiple foci of dilated vascular area is a useful predictor for stratifying the risk of metachronous esophageal SCC.
预测食管鳞癌（SCC）的风险，无需进行内镜下碘染色，因为这种染色会刺激食管。在之前的回顾性研究中，我们发现窄带成像（NBI）/蓝激光成像（BLI）下观察到的食管黏膜多发扩张血管区（MDV）与未染色碘的病变有关，因此可能是食管 SCC 的预测指标。本前瞻性研究旨在探讨 MDV 与食管 SCC 异时性之间的关系。
纳入了有内镜下切除食管 SCC 病史的患者。首先，在初次内镜检查时使用 NBI 或 BLI 评估 MDV。然后通过内镜监测来监测患者的异时性食管 SCC。研究了 MDV 的数量与异时性食管 SCC 发生率之间的关系。
2018 年 2 月至 2019 年 5 月，共纳入 206 例患者，201 例患者纳入分析。患者随访至 2022 年 10 月。内镜随访的中位（四分位间距）时间为 1260（1105-1348）天。MDV≤4 者的 2 年异时性食管 SCC 发生率为 7.1%，MDV≥5 者的发生率为 13.9%（P<0.01）。多因素分析显示，MDV 是异时性食管 SCC 的独立预测因子，优势比（95%置信区间）为 2.37（1.06-5.31）。
多发扩张血管区是分层异时性食管 SCC 风险的有用预测指标。
