Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy
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 p...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Baishideng Publishing Group Inc
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107600/ https://www.ncbi.nlm.nih.gov/pubmed/27895406 http://dx.doi.org/10.3748/wjg.v22.i41.9196 |
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author | Dobashi, Akira Goda, Kenichi Yoshimura, Noboru Ohya, Tomohiko R Kato, Masayuki Sumiyama, Kazuki Matsushima, Masato Hirooka, Shinichi Ikegami, Masahiro Tajiri, Hisao |
author_facet | Dobashi, Akira Goda, Kenichi Yoshimura, Noboru Ohya, Tomohiko R Kato, Masayuki Sumiyama, Kazuki Matsushima, Masato Hirooka, Shinichi Ikegami, Masahiro Tajiri, Hisao |
author_sort | Dobashi, Akira |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5107600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-51076002016-11-28 Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy Dobashi, Akira Goda, Kenichi Yoshimura, Noboru Ohya, Tomohiko R Kato, Masayuki Sumiyama, Kazuki Matsushima, Masato Hirooka, Shinichi Ikegami, Masahiro Tajiri, Hisao World J Gastroenterol Retrospective Study 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. Baishideng Publishing Group Inc 2016-11-07 2016-11-07 /pmc/articles/PMC5107600/ /pubmed/27895406 http://dx.doi.org/10.3748/wjg.v22.i41.9196 Text en ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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. |
spellingShingle | Retrospective Study Dobashi, Akira Goda, Kenichi Yoshimura, Noboru Ohya, Tomohiko R Kato, Masayuki Sumiyama, Kazuki Matsushima, Masato Hirooka, Shinichi Ikegami, Masahiro Tajiri, Hisao Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy |
title | Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy |
title_full | Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy |
title_fullStr | Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy |
title_full_unstemmed | Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy |
title_short | Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy |
title_sort | simplified criteria for diagnosing superficial esophageal squamous neoplasms using narrow band imaging magnifying endoscopy |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107600/ https://www.ncbi.nlm.nih.gov/pubmed/27895406 http://dx.doi.org/10.3748/wjg.v22.i41.9196 |
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