Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2024; 16(8): 3471-3480
Published online Aug 15, 2024. doi: 10.4251/wjgo.v16.i8.3471
Microvascular structural changes in esophageal squamous cell carcinoma pathology according to intrapapillary capillary loop types under magnifying endoscopy
Wei-Yang Shu, Yan-Yan Shi, Jiu-Tian Huang, Ling-Mei Meng, He-Jun Zhang, Rong-Li Cui, Yuan Li, Shi-Gang Ding
Wei-Yang Shu, Jiu-Tian Huang, Ling-Mei Meng, Yuan Li, Shi-Gang Ding, Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China
Yan-Yan Shi, Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 10019, China
He-Jun Zhang, Rong-Li Cui, Department of Gastroenterology Pathology Laboratory, Peking University Third Hospital, Beijing 100191, China
Yuan Li, Department of Gastroenterology, Peking University International Hospital, Beijing 102206, China
Co-first authors: Wei-Yang Shu and Yan-Yan Shi.
Co-corresponding authors: Yuan Li and Shi-Gang Ding.
Author contributions: Shu WY and Shi YY contributed equally to this work; Li Y and Ding SG designed the research study; Shu WY, Huang JT, Cui RL, and Zhang HJ performed the research; Shi YY contributed analytic tools and methods; Shu WY, Shi YY, Huang JT, Meng LM, Cui RL, and Zhang HJ analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript. Li Y and Ding SG contributed equally to this work as co-corresponding authors—the reasons for designating Li Y and Ding SG as co-corresponding authors are twofold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, Li Y and Ding SG contributed efforts of equal substance throughout the research process. The choice of these researchers as co-corresponding authors acknowledges and respects this equal contribution while recognizing the spirit of teamwork and collaboration in this study. In summary, we believe that designating Li Y and Ding SG as co-corresponding authors fits our manuscript as it accurately reflects our team's collaborative spirit and equal contributions.
Supported by Beijing Science and Technology Development Program (Medical and Pharmaceutical Science Project), No. 7232200.
Institutional review board statement: All the experimental protocols were approved by the Medical Ethics Committee of Peking University Third Hospital (Approval No. IRB00006761-M2023341).
Informed consent statement: An application for exemption from informed consent had been made for this study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan Li, MD, PhD, Associate Professor, Chief Physician, Department of Gastroenterology, Peking University International Hospital, No. 1 Life Park Road, Zhongguancun Life Science Park, Changping District, Beijing 102206, China. leeeyuan@aliyun.com
Received: January 25, 2024
Revised: March 8, 2024
Accepted: June 3, 2024
Published online: August 15, 2024
Processing time: 195 Days and 13.3 Hours
Abstract
BACKGROUND

The intrapapillary capillary loop (IPCL) characteristics, visualized using magnifying endoscopy, are commonly assessed for preoperative evaluation of the infiltration depth of esophageal squamous cell carcinoma (ESCC). Japan Esophageal Society (JES) classification is the most widely used classification. Microvascular structural changes are evaluated by magnifying endoscopy for the presence or absence of each morphological factor: tortuosity, dilatation, irregular caliber, and different shapes. However, the pathological characteristics of IPCLs have not been thoroughly investigated, especially the microvascular structures corresponding to the deepest parts of the lesions' infiltration.

AIM

To investigate differences in pathological microvascular structures of ESCC, which correspond to the deepest parts of the lesions' infiltration.

METHODS

Patients with ESCC and precancerous lesions diagnosed at Peking University Third Hospital were enrolled between January 2019 and April 2023. Patients first underwent magnified endoscopic examination, followed by endoscopic submucosal dissection or surgical treatment. Pathological images were scanned using a three-dimensional slice scanner, and the pathological structural differences in different types, according to the JES classification, were analyzed using nonparametric tests and t-tests.

RESULTS

The 35 lesions were divided into four groups according to the JES classification: A, B1, B2, and B3. Statistical analyses revealed significant differences (aP < 0.05) in the short and long calibers, area, location, and density between types A and B. Notably, there were no significant differences in these parameters between types B1 and B2 and between types B2 and B3 (P > 0.05). However, significant differences in the short calibers, long calibers, and area of IPCL were observed between types B1 and B3 (aP < 0.05); no significant differences were found in the density or location (P > 0.05).

CONCLUSION

Pathological structures of IPCLs in the deepest infiltrating regions differ among various IPCL types classified by the JES classification under magnifying endoscopy, especially between the types A and B.

Keywords: Esophageal squamous cell carcinoma; Intrapapillary capillary loop; The Japan Esophageal Society classification; Magnifying endoscopy; Pathological characteristics

Core Tip: Based on the Japan Esophageal Society (JES) classification, this study first clarified the differences in pathological microvascular structures of esophageal squamous cell carcinoma, which correspond to the deepest parts of the lesions’ infiltration. The results show significant differences in the pathological structures of the intrapapillary capillary loops, which correspond to the deepest parts of the lesions’ infiltration, between the different types. This finding might help optimize the JES classification and potentially advance the accuracy of endoscopic biopsy diagnosis.