Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2022; 14(9): 986-996
Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.986
Study of preoperative diagnostic modalities in Chinese patients with superficial esophageal squamous cell carcinoma
Ya-Ting Zeng, Yu-Ying Sun, Wen-Cheng Tan, Shu-Ai Luo, Bi-Hui Zou, Guang-Yu Luo, Chun-Yu Huang
Ya-Ting Zeng, Yu-Ying Sun, Wen-Cheng Tan, Shu-Ai Luo, Bi-Hui Zou, Guang-Yu Luo, Chun-Yu Huang, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Ya-Ting Zeng, Yu-Ying Sun, Wen-Cheng Tan, Shu-Ai Luo, Bi-Hui Zou, Guang-Yu Luo, Chun-Yu Huang, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Ya-Ting Zeng, Wen-Cheng Tan, Shu-Ai Luo, Bi-Hui Zou, Guang-Yu Luo, Chun-Yu Huang, Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Yu-Ying Sun, Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Author contributions: Zeng Y designed and performed the study and wrote the manuscript; Sun Y and Huang C contributed to the conception of the study; Tan W and Luo G helped perform the analysis with constructive discussions; Luo S and Zhou B collected the data;
Supported by the Guangdong Esophageal Cancer Institute Science and Technology Program, No. M202013.
Institutional review board statement: This study was approved by the Ethics Committee of the Sun Yat-Sen University Cancer Center.
Informed consent statement: Informed consent from patients was waived by the Ethics Committee of the Sun Yat-Sen University Cancer Center.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
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: Chun-Yu Huang, MD, PhD, Professor, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou 510060, Guangdong Province, China. huangchy@sysucc.org.cn
Received: June 9, 2022
Peer-review started: June 9, 2022
First decision: August 1, 2022
Revised: August 11, 2022
Accepted: September 8, 2022
Article in press: September 8, 2022
Published online: September 27, 2022
ARTICLE HIGHLIGHTS
Research background

Early-stage detection and treatment of esophageal carcinoma can typically optimize prognosis. Compared with traditional surgery, endoscopic resection is a less invasive and potentially curative treatment for early-stage esophageal cancer. Identification of patients that are candidates for endoscopic resection is crucial. Endoscopic ultrasonography (EUS) and magnifying endoscopy (ME) reliably determine indications for endoscopic resection in patients with superficial esophageal squamous cell carcinoma (SESCC). ME is a widely accepted method for predicting the invasion depth of superficial esophageal cancer with satisfying accuracy. However, the addition of EUS is controversial.

Research motivation

To evaluate the diagnostic efficiency of ME vs EUS for invasion depth prediction, and investigate the influencing factors.

Research objectives

To determine the most suitable preoperative diagnostic modality for Chinese patients with SESCC.

Research methods

We retrospectively analyzed patients with suspected SESCC who completed both ME and EUS and then underwent endoscopic or surgical resection at Sun Yat-Sen University Cancer Center between January 2018 and December 2021. We evaluated and compared the diagnostic efficiency of EUS and ME according to histological results, and investigated the influencing factors.

Research results

EUS and ME demonstrated comparable accuracy for determining the depth of invasion of early-stage esophageal cancers, and EUS can compensate for deficiencies inherent to NBI in some cases. The miniature probe was best suited for detecting early-stage lesions

Research conclusions

Preoperative diagnosis of SESCC should be conducted endoscopically using white light and magnification. In China, EUS can be added after obtaining patient consent. Use of a high-frequency miniature probe or miniature probe combined with conventional EUS is preferable.

Research perspectives

Future studies are required to explore how to combine the findings of ME and EUS to make a comprehensive preoperative evaluation, instead of solely depending on the experience of endoscopists.