• Digestive system endoscopy
• Disease progression
• Esophageal squamous cell carcinoma
• Head and neck squamous cell carcinoma
• Synchronous neoplasms

• Humans
• Male
• Female
• Retrospective Studies
• Middle Aged
• Aged
• Squamous Cell Carcinoma of Head and Neck/therapy
• Squamous Cell Carcinoma of Head and Neck/pathology
• Esophageal Neoplasms/therapy
• Esophageal Neoplasms/pathology
• Neoplasms, Multiple Primary/therapy
• Neoplasms, Multiple Primary/pathology
• Esophageal Squamous Cell Carcinoma/therapy
• Esophageal Squamous Cell Carcinoma/pathology
• Head and Neck Neoplasms/therapy
• Head and Neck Neoplasms/pathology
• Chemoradiotherapy/methods
• Endoscopy, Digestive System/methods
• Disease Progression
• Aged, 80 and over

• early diagnosis of cancer
• early treatment of cancer
• esophageal cancer
• gastrointestinal endoscopy
• screening

• diagnostic biopsy
• esophageal cancer
• esophago-gastric junction cancer
• histologic classification
• survival risk

• CNVGVMMATT GVM Care and Research Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna
• 5×1000-2022-2024 Italian Ministry of Health

• Artificial intelligence
• Deep learning
• Esophageal squamous cell carcinoma
• Machine learning
• Precision tumor therapy

• Humans
• Esophageal Squamous Cell Carcinoma/therapy
• Esophageal Squamous Cell Carcinoma/pathology
• Esophageal Squamous Cell Carcinoma/mortality
• Esophageal Squamous Cell Carcinoma/diagnosis
• Artificial Intelligence
• Esophageal Neoplasms/therapy
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/mortality
• Esophageal Neoplasms/diagnosis
• Precision Medicine/methods
• Prognosis
• Clinical Decision-Making/methods
• Early Detection of Cancer/methods
• Medical Oncology/methods
• Medical Oncology/trends

• body mass index
• esophageal cancer
• head and neck cancer
• lymphocyte to monocyte ratio
• survival
• synchronous cancers
• systemic inflammatory response markers

• Humans
• Male
• Female
• Middle Aged
• Esophageal Neoplasms/mortality
• Esophageal Neoplasms/pathology
• Head and Neck Neoplasms/mortality
• Head and Neck Neoplasms/pathology
• Head and Neck Neoplasms/immunology
• Head and Neck Neoplasms/blood
• Prognosis
• Aged
• Neoplasms, Multiple Primary/pathology
• Neoplasms, Multiple Primary/mortality
• Neutrophils
• Retrospective Studies
• Squamous Cell Carcinoma of Head and Neck/mortality
• Squamous Cell Carcinoma of Head and Neck/immunology
• Lymphocyte Count
• Adult
• Lymphocytes

• EDAHP107059 E-Da Hospital
• EDAHS111018 E-Da Hospital
• MOHW111-TDU-B-221-114006 Ministry of Health and Welfare
• MOST-110-2314-B-650-003 Ministry of Science and Technology, Taiwan

• decorrelated color space
• entropy
• hyperspectral imaging
• narrow band imaging
• peak-signal-to-noise ratio
• structural similarity index metric
• video capsule endoscopy

• NSTC 112-2221-E-194-036 National Science and Technology Council, Republic of China
• CCU-NTUHYB-112-NC002 National Chung Cheng University-National Taiwan University Hospital Yunlin Branch Joint Re-search Program
• 112-C001 National Taiwan University Hospital Yunlin Branch
• 112-010 Kaohsiung Armed Forces General Hospital

• endoscopic resection
• endoscopic submucosal dissection
• head and neck cancer
• superficial esophageal squamous cell neoplasm
• synchronous

• Endoscopic eradication therapy
• Epidemiology
• Esophageal squamous cell carcinoma
• Neoadjuvant chemoradiotherapy
• Prognosis

Esophageal squamous cell carcinoma (ESCC) is a common second primary neoplasia in patients with a history of head and neck squamous cell carcinoma (HNSCC). The aim of this study was to provide further information and novel insights into the risk factors for ESCC in patients with HNSCC.

We retrospectively analyzed 98 HNSCC patients diagnosed from 2007 to 2017, 30 HNSCC patients suffering from ESCC, who had undergone endoscopic examination because of positive imaging examinations or symptoms, and 68 HNSCC patients who had no ESCC occurrence for at least six years post-HNSCC diagnosis. Associated clinicopathological data and lifestyle information of the ESCC group and the without ESCC group were collected, and a case-control study of risk factors was analyzed between the two groups.

The majority (83.4%) of the cases with HNSCC esophageal cancers were male patients over 50 years. We established that 93.75% (30/32) of the ESCC occurred within six years after HNSCC diagnosis. HNSCC location, stage, and radiotherapy history had no significant association with the development of ESCC. High Ki67 labeling index (Ki67 LI) (>46) patients tended to be 3.1 times (95% CI = 1.3–7.6) more likely to develop ESCC compared to low Ki67 LI (≤45) patients (P < 0.05). Drinkers with alcohol flushing response were at a 3.3 times higher risk to have ESCC (95% CI = 1.0–10.4) than drinkers without flush response (P < 0.05).

HNSCC patients, especially drinkers with an alcohol flushing response, as well as those with high Ki67 LI of HNSCC tissue, were more likely to develop ESCC.

• comparative effectiveness
• endoscopic exam
• esophageal cancer
• oral cancer
• stage-shift effect

• Artificial Intelligence
• Endoscopy
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/pathology
• Esophageal Squamous Cell Carcinoma/diagnosis
• Humans
• Margins of Excision

• head and neck cancer
• pathological diagnosis
• resection margins
• the DiveScope cell morphology analyzer

• Free flap
• Hypopharyngeal cancer
• Outcomes
• Pharyngolaryngoesopha-gectomy

The detection rate of narrow-band imaging (NBI) for superficial esophageal squamous cell carcinoma (SESCC), including high-grade intraepithelial neoplasia, is significantly higher than that of white-light endoscopy. However, there are SESCCs that are undetectable by NBI but detectable by Lugol chromoendoscopy (LCE) and the characteristics of these SESCCs are still unknown. Thus, this study aimed to clarify the characteristics of SESCC that are undetectable using NBI.

Patients with current SCC or a history of SCC in the head and neck or in the esophagus were enrolled. The inspection of the esophagus was initiated by NBI, followed by LCE. Biopsies were taken of all suspected SESCC lesions during NBI observation and Lugol-voiding lesions (LVLs) that were irregularly shaped and >5 mm and/or pink in color during LCE observation. The characteristics of SESCC that were undetectable with NBI were statistically analysed.

Overall, 147 lesions in 105 cases were histologically diagnosed as SESCC. Twenty in 15 cases were NBI-undetectable lesions, all of which were macroscopic flat type (0-IIb). The median sizes of the NBI-undetectable lesions and NBI-detectable lesions were both 15 mm (P = 0.47). Multivariate analysis revealed independent factors for NBI-undetectable lesions such as numerous irregularly shaped LVLs (odds ratio [OR]: 4.94, 95% confidence interval [CI]: 1.39–17.5, P < 0.05) and anterior wall position (OR: 4.99, 95% CI: 1.58–15.8, P < 0.05).

The detection of SESCCs with NBI is challenging when lesions are morphologically completely flat, in cases with numerous irregularly shaped LVLs, and if located at the anterior wall.

• Lugol chromoendoscopy
• Lugol-voiding lesions
• esophageal squamous cell carcinoma
• narrow-band imaging

• Adult
• Aged
• Esophageal Neoplasms/pathology
• Esophagoscopy/methods
• Female
• Humans
• Male
• Middle Aged
• Neoplasms, Second Primary/diagnosis
• Neoplasms, Second Primary/epidemiology
• Neoplasms, Second Primary/physiopathology
• Prevalence
• Risk Factors

• ductal involvement
• endoscopic submucosal dissection
• esophageal gland
• esophageal squamous cell neoplasia
• metastasis
• recurrence
• survival

• dysplasia
• esophageal white lesion
• leukoplakia
• white-light endoscopy

Advanced esophageal cancer is known to have a poor prognosis. The early detection of esophageal neoplasms, including esophageal dysplasia and early esophageal cancer, is highly important for the accurate treatment of the disease. However, esophageal dysplasia and early esophageal cancer are usually subtle and can be easily missed. In addition to the early detection, proper pretreatment evaluation of the depth of invasion of esophageal cancer is very important for curative treatment. The progression of non-invasive diagnosis via image-enhanced endoscopy techniques has been shown to aid the early detection and estimate the depth of invasion of early esophageal cancer and, as a result, may provide additional opportunities for curative treatment. Here, we review the advancement of image-enhanced endoscopy-related technologies and their role in the early identification of esophageal neoplasms.

• Diagnostic imaging
• Early detection of cancer
• Esophageal neoplasms
• Narrow-band imaging

• Barrett's esophagus
• Esophageal adenocarcinoma
• Esophageal squamous cell carcinoma
• Mucosal imaging
• Narrow band imaging

• Barrett Esophagus/diagnostic imaging
• Esophageal Neoplasms/diagnostic imaging
• Esophagoscopy
• Humans
• Mucous Membrane
• Narrow Band Imaging

Esophageal cancer (EC) has a poor prognosis when the diagnosis is delayed, but curative treatment is possible if the diagnosis is timely. The disease subtly progresses before symptoms prompt patients to seek medical attention. Effective pre-symptomatic screening strategies may improve the outcome of the disease. Recent evidence provided insights into early diagnosis of EC via blood tests, advanced endoscopic imaging, and artificial intelligence. Accordingly, we reviewed available strategies to diagnose early EC.

Esophageal cancer (EC) is the seventh most common cancer and the sixth cause of cancer death worldwide. Histologically, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) account for up to 90% and 20% of all ECs, respectively. Clinical symptoms such as dysphagia, odynophagia, and bolus impaction occur late in the natural history of the disease, and the diagnosis is often delayed. The prognosis of ESCC and EAC is poor in advanced stages, being survival rates less than 20% at five years. However, when the diagnosis is achieved early, curative treatment is possible, and survival exceeds 80%. For these reasons, mass screening strategies for EC are highly desirable, and several options are currently under investigation. Blood biomarkers offer an inexpensive, non-invasive screening strategy for cancers, and novel technologies have allowed the identification of candidate markers for EC. The esophagus is easily accessible via endoscopy, and endoscopic imaging represents the gold standard for cancer surveillance. However, lesion recognition during endoscopic procedures is hampered by interobserver variability. To fill this gap, artificial intelligence (AI) has recently been explored and provided encouraging results. In this review, we provide a summary of currently available options to achieve early diagnosis of EC, focusing on blood biomarkers, advanced endoscopy, and AI.

• advanced endoscopy
• artificial intelligence
• biomarkers
• diagnosis
• early neoplasia
• esophageal cancer

• Retrospective study
• endoscopy
• esophageal neoplasms
• mouth neoplasms

• EUS
• cancer
• catheter probes
• high-frequency ultrasound
• intraductal ultrasound
• miniprobes

Conventional gastrointestinal (GI) endoscopy reports written by physicians are time consuming and might have obvious heterogeneity or omissions, impairing the efficiency and multicenter consultation potential. We aimed to develop and validate an image recognition–based structured report generation system (ISRGS) through a multicenter database and to assess its diagnostic performance.

First, we developed and evaluated an ISRGS combining real-time video capture, site identification, lesion detection, subcharacteristics analysis, and structured report generation. White light and chromoendoscopy images from patients with GI lesions were eligible for study inclusion. A total of 46,987 images from 9 tertiary hospitals were used to train, validate, and multicenter test (6:2:2). Moreover, 5,699 images were prospectively enrolled from Qilu Hospital of Shandong University to further assess the system in a prospective test set. The primary outcome was the diagnosis performance of GI lesions in multicenter and prospective tests.

The overall accuracy in identifying early esophageal cancer, early gastric cancer, early colorectal cancer, esophageal varices, reflux esophagitis, Barrett’s esophagus, chronic atrophic gastritis, gastric ulcer, colorectal polyp, and ulcerative colitis was 0.8841 (95% confidence interval, 0.8775–0.8904) and 0.8965 (0.8883–0.9041) in multicenter and prospective tests, respectively. The accuracy of cecum and upper GI site identification were 0.9978 (0.9969–0.9984) and 0.8513 (0.8399–0.8620), respectively. The accuracy of staining discrimination was 0.9489 (0.9396–0.9568). The relative error of size measurement was 4.04% (range 0.75%–7.39%).

ISRGS is a reliable computer-aided endoscopic report generation system that might assist endoscopists working at various hospital levels to generate standardized and accurate endoscopy reports (http://links.lww.com/CTG/A485).

• Enhanced imaging
• Esophageal cancer
• Head and neck cancer
• Lugol chromoendoscopy
• Second primary tumor
• Virtual chromoendoscopy

This study investigated benefits of routine panendoscopy in staging of oral squamous cell cancer patients.

From 2013 to 2017, 194 oral squamous cell cancer patients were staged. Reports of routine flexible panendoscopy including oropharyngolaryngoscopy, bronchoscopy, and esophagogastroduodenoscopy were retrospectively analyzed for diagnoses of inflammation and second primary malignancies (carcinoma in situ or cancer) and compared to results of computed tomography. The effects of alcohol and tobacco history of 142 patients were assessed.

Overall, a second primary malignancy was detected in seven patients. In four patients this discovery was only found by panendoscopy. One invasive carcinoma (esophagus) was detected as well as three carcinoma in situ. The second primary malignancies were located in the lung (3), esophagus (3), and stomach (1). In one patient index tumor therapy was modified after panendoscopy. Upper gastrointestinal inflammation was present in 73.2% of patients and 61.9% required treatment. About 91.8% of bronchoscopies and 34.5% of panendoscopies were without therapeutic consequences. Patients with higher risk from smoking were more likely to benefit from panendoscopy and to have a Helicobacter pylori infection.

We do not recommend routine panendoscopy for all oral squamous cell cancer patients. Esophagogastroduodenoscopy benefitted smoking patients primarily concerning the secondary diagnosis of inflammation of the upper digestive tract. Selective bronchoscopy, esophagogastroduodenoscopy, and oropharyngolaryngoscopy should be performed if clinical examination or medical history indicates risks for additional malignancies of the upper aerodigestive tract.

Routine panendoscopy is not recommended in all, especially not in low-risk oral cancer patients like non-smokers and non-drinkers.

• Gastrointestinal inflammation
• National guidelines
• Oral cancer
• Routine panendoscopy
• Synchronous second primary cancer

• early esophageal cancer
• endoscopic treatment
• esophageal varices
• liver cirrhosis
• transjugular intrahepatic portosystemic shunt

• Diagnosis
• Dual-focus
• Esophageal squamous cell carcinoma
• Intrapapillary capillary loop
• Narrow-band imaging

The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the oesophagus.

To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive stricture.

This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children’s Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and dysplasia.

The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance (potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessions was 37.2 ± 14.9. Histopathological examination of the specimens showed that 85% of patients had evidence of chronic oesophagitis (group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia (group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients (2%) had mild squamous dysplasia (group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's iodine.

The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepithelial inflammatory cellular infiltration and dysplasia. Dysplasia is one of the complications of post-corrosive oesophageal stricture.

• Children
• Endoscopic dilatation
• Dysplasia
• Oesophageal strictures
• Post-corrosive

• Adolescent
• Biopsy
• Burns, Chemical/complications
• Burns, Chemical/etiology
• Caustics/toxicity
• Child
• Child, Preschool
• Dilatation/methods
• Egypt
• Esophageal Mucosa/diagnostic imaging
• Esophageal Mucosa/drug effects
• Esophageal Mucosa/pathology
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/prevention & control
• Esophageal Stenosis/chemically induced
• Esophageal Stenosis/diagnostic imaging
• Esophageal Stenosis/pathology
• Esophageal Stenosis/surgery
• Esophagitis/chemically induced
• Esophagitis/diagnostic imaging
• Esophagitis/pathology
• Esophagoscopy/methods
• Female
• Humans
• Male

• Adult
• Aged
• Aged, 80 and over
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/mortality
• Esophageal Neoplasms/pathology
• Female
• Hospitals
• Humans
• Male
• Middle Aged
• Mozambique
• Survival Rate

This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) and Lugol’schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamous cell neoplasms (ESCNs) in patients with a history of head and neck cancer.

From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology has historically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined.

Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelial neoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy of dNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively.

The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detecting esophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guided biopsy could reduce the number of unnecessary biopsies.

• Early esophageal squamous cell neoplasm
• Lugol’s chromoendoscopy
• Narrow-band imaging
• Probe-based confocal laser endomicroscopy

• Field cancerization
• esophageal cancer
• head and neck cancer
• hypopharyngeal cancer
• oral cancer
• squamous cell carcinoma

• Radiofrequency ablation
• adverse event
• endoscopic ultrasound
• esophageal squamous cell neoplasia
• stricture
• tissue effect