Endoscopic Features of Basaloid Squamous Cell Carcinoma of Esophagus at Early Stage / 胃肠病学

ABSTRACT

Background: Esophageal basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma characterized by aggressive biological behavior and poor prognosis. Curative resection at early stage can significantly improve the outcome of patients with esophageal BSCC. Endoscopic biopsy is the main approach for the diagnosis of early esophageal cancer, however, the endoscopic features of early esophageal BSCC have not yet been systematically studied. Aims: To summarize the endoscopic features of early esophageal BSCC. Methods: The clinical, endoscopic and pathological data of 5 cases of early esophageal BSCC confirmed by pathology of endoscopic submucosal dissection from June 2016 to March 2019 at the Affiliated Drum Tower Hospital of Nanjing University Medical School were retrospectively analyzed. Results: The patients were 5 males with a mean age of 61 years old. Most of the lesions were located in the middle thoracic esophagus (3/5); the long diameter was equal to or more than 3 cm (4/5), and near 50% circumference of the esophagus was involved (5/5). All of the 5 lesions were presented as endoscopic type Ⅱb. Most of the lesions showed only mucosal roughness under white light endoscopy and there were no obvious demarcation or background color changes under narrow-band imaging. Intrapapillary capillary loop (IPCL) was categorized as type B1 with low density under magnifying endoscopy in four cases. Iodine staining revealed less-stained or no staining in all the cases. Postoperative pathological results showed T1a tumor in all the cases. Conclusions: The endoscopic findings of early esophageal BSCC were occult. Most of the cases only show rough and flat lesion without other obvious specific changes. Type B1 microvessels with a low density under magnifying endoscopy might be a characteristic feature of early esophageal BSCC.