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Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy

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World Journal of Gastroenterology 2016年第41期22卷 9196-9204页

作者： Akira Dobashi Kenichi Goda Noboru Yoshimura Tomohiko R Ohya Masayuki Kato Kazuki Sumiyama Masato Matsushima Shinichi Hirooka Masahiro Ikegami Hisao Tajiri Department of Endoscopy The Jikei University School of Medicine Department of Endoscopy The Jikei University Katsushika Medical Center Division of Clinical Epidemiology The Jikei University School of Medicine Department of Pathology The Jikei University School of Medicine Department of Innovative Interventional Endoscopy Research The Jikei University School of Medicine

AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's *** Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria,

关键词： Simplified criteria Narrow Band Imaging Magnifying endoscopy Esophageal cancer squamous cell carcinoma Endoscopic diagnosis Classification superficial squamous cell carcinoma Stepwise logistic regression analysis

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