Maeda Hidehito, Sasaki Fumisato, Koyoshi Naohiro, Uehara Shohei, Sakae Takahiro, Tanaka Akihito, Hinokuchi Makoto, Arima Shiho, Hashimoto Shinichi, Kanmura Shuji
Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Esophagus. 2025 Sep 17. doi: 10.1007/s10388-025-01156-1.
We aimed to identify an acceptable waiting period between the diagnosis of superficial esophageal squamous cell carcinoma (SESCC) and endoscopic submucosal dissection (ESD).
This retrospective, single-center study included 423 patients with 514 SESCC lesions. All patients underwent image-enhanced magnifying endoscopy at initial evaluation and on the day of ESD. Following three outcomes were assessed: the diagnostic accuracy of tumor invasion depth on the day of ESD using the Japanese Esophageal Society classification; changes in diagnosis between initial and final evaluations across different waiting intervals; and 5-year survival rates based on intrapapillary capillary loop patterns (B1 vs. B2) and waiting duration.
The diagnostic accuracy was 96.6% for B1 vessels (EP/LPM), 59.6% for B2 vessels (MM/SM1), and 84.6% for B3 vessels (SM2 or deeper). Among B1 lesions, 100% remained B1 on the day of ESD across all time groups. For B2 lesions, stability was observed in 100% of cases within one month, 98.2% in one to two months, 92.9% in two to three months, and 100% after three months. Five-year survival rates showed no significant differences among waiting period groups in both B1 and B2 categories.
A waiting period of 3 months is acceptable for patients with SESCC classified as B1 vessels, provided the diagnostic accuracy is maintained. Thorough endoscopic evaluation supports safe scheduling flexibility without adversely affecting long-term outcomes.
我们旨在确定浅表性食管鳞状细胞癌（SESCC）诊断与内镜下黏膜下剥离术（ESD）之间可接受的等待期。
这项回顾性单中心研究纳入了423例患有514处SESCC病变的患者。所有患者在初次评估时以及ESD当天均接受了图像增强放大内镜检查。评估了以下三项结果：使用日本食管学会分类法在ESD当天对肿瘤浸润深度的诊断准确性；不同等待间隔下初次评估与最终评估之间的诊断变化；以及基于乳头内毛细血管袢模式（B1与B2）和等待时间的5年生存率。
B1血管（上皮乳头内毛细血管袢/黏膜肌层）的诊断准确率为96.6%，B2血管（黏膜下层浅层/黏膜下层深层）为59.6%，B3血管（黏膜下层深层或更深层）为84.6%。在B1病变中，所有时间组的病变在ESD当天均保持为B1。对于B2病变，100%的病例在1个月内保持稳定，1至2个月内为98.2%，2至3个月内为92.9%，3个月后为100%。B1和B2类别的等待期组之间的5年生存率无显著差异。
对于分类为B1血管的SESCC患者，3个月的等待期是可以接受的，前提是保持诊断准确性。全面的内镜评估支持安全的时间安排灵活性，而不会对长期结果产生不利影响。
