Ishida Natsuki, Osawa Satoshi, Sugiura Kiichi, Takebe Tomohiro, Takahashi Kenichi, Asai Yusuke, Tamura Satoshi, Matsuura Tomoharu, Yamade Mihoko, Iwaizumi Moriya, Hamaya Yasushi, Yamada Takanori, Sugimoto Ken
First Department of Medicine Hamamatsu University School of Medicine Hamamatsu Japan.
Department of Endoscopic and Photodynamic Medicine Hamamatsu University School of Medicine Hamamatsu Japan.
JGH Open. 2024 Dec 6;8(12):e70063. doi: 10.1002/jgh3.70063. eCollection 2024 Dec.
In terms of their longitudinal positioning, esophageal squamous cell carcinoma (ESCC) commonly arises in the middle segment of the esophagus. However, limited attention has been given to the circumferential aspect. This study aimed to investigate the prevalence and characteristics of ESCC lesions resected via endoscopic submucosal dissection (ESD), taking into consideration both longitudinal and circumferential positions.
We retrospectively evaluated 193 ESD-resected ESCC lesions and compared the occurrence rate of ESCC development and the degree of histopathological invasion across various circumferential and longitudinal positions. We scrutinized lesion characteristics by location, with a particular focus on the proportion of early-stage small lesions in each site.
Regarding lesion location, 27 were situated on the anterior wall, 62 on the left, 66 on the posterior, and 38 on the right. Among the four circumferential positions, the anterior wall group had the smallest median tumor size. Additionally, the anterior wall group had the highest proportions of lesions with invasion depths limited to the epithelial layer and sizes < 10 mm, at 44.4% and 25.9%, respectively. Furthermore, a significant difference was noted among the four circumferential positions with respect to the proportion of ESCC lesions satisfying both criteria, with the highest proportion observed in the anterior wall group ( = 0.049).
Our findings suggest that while ESCC occurrence on the anterior wall is less frequent, these lesions may present as small lesions with superficial invasion depths.
就纵向位置而言，食管鳞状细胞癌（ESCC）通常发生于食管中段。然而，对于其周向方面的关注有限。本研究旨在探讨经内镜黏膜下剥离术（ESD）切除的ESCC病变的发生率及特征，同时考虑纵向和周向位置。
我们回顾性评估了193例经ESD切除的ESCC病变，并比较了不同周向和纵向位置的ESCC发生率及组织病理学浸润程度。我们按位置仔细研究病变特征，特别关注每个部位早期小病变的比例。
关于病变位置，27例位于前壁，62例位于左侧，66例位于后壁，38例位于右侧。在四个周向位置中，前壁组的肿瘤中位大小最小。此外，前壁组浸润深度局限于上皮层且大小<10 mm的病变比例最高，分别为44.4%和25.9%。此外，四个周向位置在满足两个标准的ESCC病变比例方面存在显著差异，前壁组的比例最高（=0.049）。
我们的研究结果表明，虽然ESCC在前壁的发生率较低，但这些病变可能表现为浸润深度较浅的小病变。
