雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

The Diagnostic Accuracy of the Japan Esophageal Society Classification for Superficial Esophageal Squamous Cell Carcinoma Akihisa Tomori 1 , Tsuneo Oyama 1 , Akiko Takahashi 1 , Takaaki Kishino 1 , Tomoaki Shinohara 1 , Kenji Kunieda 1 , Toshiyuki Wakatsuki 1 , Shinichirou Takeda 1 1Department of Gastroenterology, Saku Central Hospital, Saku, Japan Keyword: 食道表在癌 , 隆起型 , 深達度診断 , 拡大内視鏡 , 日本食道学会拡大内視鏡分類 pp.337-345
Published Date 2013/3/25
DOI https://doi.org/10.11477/mf.1403113748
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 A new classification of magnified endoscopic findings for esophageal squamous cell carcinoma was developed by the JES(Japan esophageal society)classification. It is a simple classification, and widely accepted. However, its usefulness for the diagnosis of invasion depth of protuberant lesions was unknown.

 Patients and method : 40 protuberant esophageal SCC〔squamous cell carcinoma(0-I or 0-IIa)〕from 351 esophageal SCC treated by ESD(endoscopic submucosal dissection)in Saku Central Hospital from November 2008 to Oct 2012 were enrolled in this study. Invasion depth was classified into three groups ; Ep-LPM, MM-SM1 and SM2 according to the Japanese classification. The invasion depth was diagnosed as EP-LPM, MM-SM1 and SM2 based on the JES classification B1, B2 and B3.

 Result : 14 of 18, 4 of 13 and 1 of 1 in the B1, B2 and B3 group were diagnosed correctly. Therefore, the accuracy was 48%.

 Discussion : There were 3 major factors for misdiagnosis. The first was difficulty of observation. The vascular pattern was not able to be observed in 8 of 40 lesions, because of hyperkeratinization or erosion. However, the invasion depth of such lesions could be diagnosed correctly by WL(white light)endoscopy. The second factor was a unique invasion pattern(submucosal tumor-like invasion). Sometimes the invaded SCC was covered by EP-LPM SCC, and the surface vascular pattern was B1 in such cases. However, the lesion was able to be diagnosed as submucosal invaded SCC from submucosal tumor-like findings by WL endoscopy. The final factor was low accuracy in B2. seven and 2 cases of 14 was Ep-LPM and SM2. However, the invasion depth has a relationship with the size of B2 area and color of the lesion. The invasion depth was EP-LPM and SM2, when the size of B2 area was 2 mm or less and 4mm or more. And the white lesion was Ep-LPM. Therefore, a combination between WL and magnified endoscopic findings may improve the accuracy.


Copyright © 2013, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

関連文献

もっと見る

文献を共有