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Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy.
World J Gastroenterol 2016; 22(41):9196-9204WJ

Abstract

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 endoscopists detected 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 criteria.

RESULTS

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, respectively.

CONCLUSION

The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBI-ME.

Authors+Show Affiliations

Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.Akira Dobashi, Kenichi Goda, Noboru Yoshimura, Tomohiko R Ohya, Kazuki Sumiyama, Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27895406

Citation

Dobashi, Akira, et al. "Simplified Criteria for Diagnosing Superficial Esophageal Squamous Neoplasms Using Narrow Band Imaging Magnifying Endoscopy." World Journal of Gastroenterology, vol. 22, no. 41, 2016, pp. 9196-9204.
Dobashi A, Goda K, Yoshimura N, et al. Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy. World J Gastroenterol. 2016;22(41):9196-9204.
Dobashi, A., Goda, K., Yoshimura, N., Ohya, T. R., Kato, M., Sumiyama, K., ... Tajiri, H. (2016). Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy. World Journal of Gastroenterology, 22(41), pp. 9196-9204.
Dobashi A, et al. Simplified Criteria for Diagnosing Superficial Esophageal Squamous Neoplasms Using Narrow Band Imaging Magnifying Endoscopy. World J Gastroenterol. 2016 Nov 7;22(41):9196-9204. PubMed PMID: 27895406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy. AU - Dobashi,Akira, AU - Goda,Kenichi, AU - Yoshimura,Noboru, AU - Ohya,Tomohiko R, AU - Kato,Masayuki, AU - Sumiyama,Kazuki, AU - Matsushima,Masato, AU - Hirooka,Shinichi, AU - Ikegami,Masahiro, AU - Tajiri,Hisao, PY - 2016/06/21/received PY - 2016/08/20/revised PY - 2016/09/14/accepted PY - 2016/11/30/entrez PY - 2016/11/30/pubmed PY - 2017/4/25/medline KW - Classification KW - Endoscopic diagnosis KW - Esophageal cancer KW - Magnifying endoscopy KW - Narrow Band Imaging KW - Simplified criteria KW - Squamous cell carcinoma KW - Stepwise logistic regression analysis KW - Superficial squamous cell carcinoma SP - 9196 EP - 9204 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 22 IS - 41 N2 - 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 endoscopists detected 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 criteria. RESULTS: 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, respectively. CONCLUSION: The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBI-ME. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/27895406/Simplified_criteria_for_diagnosing_superficial_esophageal_squamous_neoplasms_using_Narrow_Band_Imaging_magnifying_endoscopy_ L2 - http://www.wjgnet.com/1007-9327/full/v22/i41/9196.htm DB - PRIME DP - Unbound Medicine ER -