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Diagnosis of the Invasion Depth of Superficial Esophageal Carcinoma Using Magnifying Endoscopy with FICE Miwako Arima 1 , Hideaki Arima 2 , Masahiro Tada 1 , Youichi Tanaka 3 1Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan 2Arima Surgical-Gastrointestinal Clinic, Chiba, Japan 3Department of Gastrointestinal Surgery, Saitama Cancer Center, Saitama, Japan Keyword: 拡大内視鏡 , 食道表在癌 , 微細血管分類 , 深達度診断 , FICE pp.677-686
Published Date 2011/5/24
DOI https://doi.org/10.11477/mf.1403102227
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 We examined the results and problems involved in diagnosis of the invasion depth of superficial esophageal cancer on the basis of magnifying endoscopy obtained with FICE. A total of 267 lesions of superficial esophageal cancers were studied. When type 3 and type 4S vessels were considered the diagnostic criteria for EP/LPM cancer, type 4M and ard3 vessels for MM/SM1 cancer, and type 4L and ard4 vessels for SM2/SM3 cancer, the rate of correct diagnosis was 98.9% for EP/LPM cancer, 78.6% for MM/SM1 cancer, and 69.4% for SM2/SM3 cancer, and the overall accuracy rate was 92.5%. 12 of 13 lesions(92%)with type 4R vessels were found in poorly differentiated carcinomas, specific histologic types of carcinoma, and lesions showing INFc infiltrative patterns. Diagnostic accuracy rate of conventional endoscopiy for EP/LPM cancers is very high, but magnifying endoscopy permits a high proportion of EP/LPM cancers to be accurately diagnosed on the basis of vascular patterns, without performing biopsy, so magnifying endoscopy has thus improved diagnostic accuracy. Magnifying endoscopy allowed minute invasion to be more precisely estimated, previously not possible by conventional endoscopy. It has also enabled the evaluation of the depth and the invasion pattern of the thickned and the elevated area basis on the vascular patterns, thereby improving diagnostic accuracy for MM or T1b cancers. Misdiagnosis was caused by tumors that were covered with shallow superficial layers of cancer cells, overlying deeper areas of invasive nodular foci.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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