Japanese

Endoscopy for Superficial Cancer of the Cervical Esophagus Junko Fujiwara 1 , Kumiko Momma 1 , Yoko Tateishi 2 , Maiko Kimura 3 , Yoshitaka Tokai 3 , Yuka Kowazaki 3 , Tomonobu Suzuki 4 , Akinori Miura 4 , Tsuyoshi Kato 4 , Yousuke Izumi 4 , Tsunekazu Hishima 2 , Misao Yoshida 5 1Department of Endoscopy, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 2Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 3Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 4Department of Internal Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 5Foundation for Detection of Early Gastric Carcinoma, Tokyo Keyword: 頸部食道癌 , 内視鏡診断 , NBI , EMR , ESD pp.360-372
Published Date 2012/3/25
DOI https://doi.org/10.11477/mf.1403113126
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 Anatomical and functional features restrict endoscopic studies on the cervical esophagus. Aim of this study is to find points of endoscopic observation and availability of NBI(narrow band imaging)in detection of superficial cancer of the cervical esophagus and endoscopic estimation of depth of invasion.

 Conventional white light endoscopic observation was employed on the way going and NBI observation on the way back in this study. Sixteen patients(15 male and one female)with superficial cancer of the cervical esophagus were involved. They had been treated at our hospital from 2007 to 2010. Endoscopic treatments such as EMR(endoscopic mucosal resection)or ESD(endoscopic submucosal dissection)were employed for 14 patients and chemoradiotherapy for two patients. Pathological studies on endoscopically resected specimens revealed depth of cancer invasion : T1a-EP 6 cases(43), T1a-LPM 3(22), T1a-MM 2(14)and SM2 3(21). Type 0-IIa lesions occupied 36 of all cases, 0-IIb 7, 0-IIc 50 and 0-I 7. Endoscopic characteristics of 14 patients with endoscopic treatment were analyzed.

 Iodine staining for screening endoscopy of cervical esophagus is not recommended for strong irritations. NBI observation allowed us to find cancer lesions as well defined brownish areas that made cancer detection easy even in sites where endoscopic approaches were restricted tangentially. Endoscopy with sedation made patients relax and gave us better observation. A transparent hood on the tip of the scope allowed us to keep a distance from the mucosa required for the better observation.

 Sometimes adjacent organ compressed the cervical esophagus resulting in its deformities, restricting endoscopic observations and disturbing endoscopic estimation of depth of invasion. Closer observations with NBI allowed us to detect partial and deeper invasion in the cancer lesion. EUS(endoscopic ultrasonography) studies using miniature probe were recommended when NBI observation was not available while deeper invasion was suspected. Clinical investigations should be carried out considering facts that synchronous and metachronous multiple cancers were frequent among patients with cervical esophageal cancer.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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

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