Magnifying endoscopy in upper gastroenterology for assessing lesions before completing endoscopic removal

Table 1 Inoue’s classification of intra-papillary capillary loop in esophagus

Typing	IPCL	Iodine staining	Under NBI	Pathological assessing	Treatment
Type I	Smooth running small diameter capillary vessel with no difference from the normal pattern	Stained		Normal epithelium
Type II	Elongation and/or dilation capillary is often seen	Slightly stained		Esophagitis or re-generative tissue
Type III	No or minimal change from the normal	Unstained	Brownish	HGIEN	Further follow-up
Type IV	Showing two or three of four patterns among dilation, meandering, caliber changes and different shapes	Unstained	Brownish	HGIEN or m1 carcinoma in situ	ESD/en bloc EMR
Type V	Demonstrating all four characteristic changes: dilation, tortuous weaving, irregular caliber and form variation	Unstained	Brownish	M1 carcinoma in situ
Type VI	Elongation basing on the shapes of type V IPCL , keeping IPCL partly	Unstained	Brownish	M2 carcinoma in situ
Type VII	Destructing dramatically and running on horizontal plane	Unstained	Brownish	M3-Sm1deeper carcinoma	Relatively indicated for ESD/EMR
Type VIII	New tumor vessel appear	Unstained	Brownish	Sm2 deep carcinoma	Surgery, chemorado-therapy

IPCL: Intraepithelial papillary capillary loop; NBI: Narrow-band imaging; ESD: Endoscopic submucosal dissection; EMR: Endoscopic mucosal resection; HGIEN: High-grade intraepithelial neoplasia.