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Accuracy of the Japan Esophageal Society Classification of NBI-Magnifying Endoscopy in Diagnosing Superficial Esophageal Squamous CellCarcinoma Invasion Depth Manabu Takeuchi 1 , Satoru Hashimoto 2 , Masaaki Kobayashi 2 , Ken-ichi Mizuno 2 , Yukari Watanabe 3 , Gen Watanabe 3 , Yoichi Ajioka 3 , Shuji Terai 1 1Department of Gastroenterology and Hepatology, Niigata University Medical and Dental Hospital, Niigata, Japan 2Department of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan 3Division of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan Keyword: 食道癌 , 深達度 , 拡大内視鏡 , NBI , 日本食道学会拡大内視鏡分類 pp.553-562
Published Date 2015/5/24
DOI https://doi.org/10.11477/mf.1403200282
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 The diagnostic accuracy of invasion depth in superficial esophageal squamous cell carcinoma(SCC)was prospectively evaluated at our institute according to a new classification system established by the Japan Esophageal Society(JES). In this study, 306 consecutive lesions in 260 patients with superficial esophageal SCC and treated by endoscopic submucosal dissection(ESD)were enrolled from March 2011 to June 2014. Histologically, 241 lesions were diagnosed as pT1a-EP/LPM, 39 lesions as tumor depth of pT1a-MM or pT1b-SM1, and the remaining 26 lesions as pT1b-SM2. The accuracy rate of the tumor invasion depth of the targeted lesion diagnosed as type B1 vessels by magnifying endoscopy with narrow band imaging(NBI)was 97.4%(236/241). The accuracy rate of type B2 and B3 vessels was 73.1%(38/53)and 91.7%(11/12), respectively. The sensitivity was lowest for type B3 vessels with 47.8%. The problem associated with these results was the high incidence of type B2 vessel in pSM2 carcinomas. Although greater test accuracy is currently required regarding type B2 vessels, it is important to investigate the association between type B2 vessels and pSM2 carcinomas which may be of value in the future. On the other hand, as many targeted lesions involve deep tissues, diagnosis of tumor invasion depth using magnifying endoscopy may allow more accurate pathological assessment and appropriate evaluation of additional treatment needs.


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