ABSTRACT
Objective To evaluate the lfexible spectral imaging color enhancement (FICE) system associated with mini-probe endoscopic ultrasonography in diagnosis of superifcial esophageal lesions.Methods 292 patients with superficial esophageal lesions were randomly assigned to control group or observation group. The common white light endoscopy and magnifying endoscopy were used in the control group while FICE associated with mini-probe endoscopic ultrasonography in the observation group. Findings were compared with the pathologic diagnosis.Result The magnifying FICE could reveal the IPCL of superifcial esophageal lesions and can accurately determine the pathological types of lesions. The diagnose accordance rate of esophagitis by magnifying FICE was 82.69%, mild and moderate atypical hyperplasia highly atypical hyperplasia 86.96%. The diagnostic accuracy rate of esophagus lesions between observation group and control group was 91.78 %, 76.02 % respectively. And the diagnostic sensitive rate between two groups was 85.71%, 44.44%. The former is superior to the latter. There were 5 lfat lesions found by FICE which were missed diagnosed by white light endoscopy.Conclusion FICE can enhance the ability of identiifcation of lesion which shows the outline and morphology of lesion and can improve the biopsy accuracy. FICE associated with mini-probe endoscopic ultrasonography has a certain clinical application value in the diagnosis and treatment of superifcial esophageal lesions.
ABSTRACT
Objective To explore the clinical value of IPCL patterns for the diagnosis and treatment of esophageal superficial lesions.Methods Data of 249 esophageal superficial lesions obtained from Digestive Disease Center of Northern Yokohama Hospital were retrospectively analyzed.All specimens were classified based on Haruhiro Inoue IPCL classification,while pathological analysis was performed according to the esophageal cancer classification of Japanese Esophageal Society.The relationship between the IPCL type and pathology was investigated.Results Of all the 249 lesions,22 lesions were identified as IPCL type Ⅲwhich included 16 cases esophagitis and 6 low-grade intraepithelial neoplasm (LGIN).Twenty-nine lesions were IPCL type Ⅳ,including 11 esophagitis,4 LGIN,10 m1 cancer,and 4 m2.Seventy-one lesions were IPCL type Ⅴ1,including 54 m1 cases,8 m2 and 4 m3.Forty-eight lesions were IPCL type Ⅴ2,including 8 m1,34 m2 and 4 m3.Forty-five lesions were IPCLA type Ⅴ3,including 4 m1,19 m2,15 m3 and 4 sm1.Twenty-two lesions were IPCL type Ⅴ3B,including 5 m2,5 m3,3 sm1 and 9 cases that tumor invaded into sm2 or deeper.Twelve lesions were IPCL type Ⅴ N,including 2 sm1 cases and 9 cases that tumor invaded into sm2 or deeper.Conclusion The Haruhiro Inoue IPCL classification is useful for diagnosis and treatment of esophageal superficial lesions.IPCL type Ⅴ1,Ⅴ 2 or Ⅴ 3A indicate early esophageal cancer or esophageal cancer that invades m1-sm1,and EMR or ESD can be performed.IPCL Ⅴ N type often means tumor invades sm2 or deeper.Confronting esophageal superficial lesions of IPCL Ⅲ,Ⅳ of Ⅴ3B type,physicians should also consider the diagnosis with clinical features,biopsy and endoscopic ultrasound.
ABSTRACT
Objective To evaluate the flexible spectral imaging color enhancement (FICE) system in the diagnosis of early esophageal carcinoma and precancerous lesions.Methods A total of 257 patients with suspicious esophageal lesions were examined successively by FICE,magnifying FICE,iodine dyeing endoscopy and magnifying iodine dyeing endoscopy.Findings were compared with the pathologic diagnosis.Results The positive rates of early esophageal carcinoma by FICE (92.6％,25/27) and iodine dyeing endoscopy (88.9％,24/27) were not significantly different (P =0.642),nor were those of magnifying FICE (96.3％,26/27) and magnifying iodine dyeing endoscopy (92.6％,25/27),(P =0.556).The magnifying FICE could reveal the IPCL of early esophageal carcinoma clearly.Early esophageal carcinoma and advanced neoplasia were mainly type Ⅳ + Ⅴ,low-level neoplasia and esophagitis were type Ⅱ + Ⅲ,and normal esophagus was type Ⅰ.However,the magnifying iodine dyeing endoscopy was not able to reveal IPCL.There was no adverse reaction in FICE,but the adverse reaction rate was 12.8％ (33/257) in iodine dyeing endoscopy.Conclusion Magnifying FICE can accurately determine the pathological types of early esophageal carcinoma,which is an effective complement to iodine dyeing endoscopy.