Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2017; 23(24): 4416-4421
Published online Jun 28, 2017. doi: 10.3748/wjg.v23.i24.4416
New magnifying endoscopic classification for superficial esophageal squamous cell carcinoma
Su Jin Kim, Gwang Ha Kim, Moon Won Lee, Hye Kyung Jeon, Dong Hoon Baek, Bong Eun Lee, Geun Am Song
Su Jin Kim, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
Gwang Ha Kim, Moon Won Lee, Hye Kyung Jeon, Dong Hoon Baek, Bong Eun Lee, Geun Am Song, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Author contributions: Kim GH designed the research/study; Kim SJ, Lee MW and Jeon HK analyzed the data; Kim SJ and Kim GH performed the study; Baek DH and Lee BE collected the data; Song GA reviewed the study population data; Kim SJ and Kim GH wrote the paper; all authors read and approved the final manuscript.
Supported by the National R&D Program for Cancer Control, Ministry for Health, Welfare and Family Affairs, South Korea, No. 0920050; and the Medical Research Center Program through the National Research Foundation of Korea grant funded by the Korea government, No. NRF-2015R1A5A2009656.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Pusan National University Hospital.
Informed consent statement: Patients were not required to provide informed consent because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no conflict of interests.
Data sharing statement: Dataset are available from the corresponding author at doc0224@pusan.ac.kr. Patient consent was not obtained but the presented data are anonymous and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gwang Ha Kim, MD, PhD, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan 49241, South Korea. doc0224@pusan.ac.kr
Telephone: +82-51-2407869 Fax: +82-51-2448180
Received: January 17, 2017
Peer-review started: January 18, 2017
First decision: March 16, 2017
Revised: March 27, 2017
Accepted: June 1, 2017
Article in press: June 1, 2017
Published online: June 28, 2017
Processing time: 220 Days and 15.7 Hours
Abstract
AIM

To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC).

METHODS

This study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed.

RESULTS

Overall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95).

CONCLUSION

The recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.

Keywords: Narrow-band imaging; Esophageal cancer; Squamous cell carcinoma; Magnifying endoscopy

Core tip: Recently, the Japan Esophageal Society proposed a new magnifying endoscopic classification for superficial esophageal squamous cell carcinoma (SESCC) based on two previous classifications. This classification is simple and useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.