Clinical Significance of Type B1 Vessels in the Japan Esophageal Society Classification Akira Dobashi 1 , Kenichi Goda 1 , Hiroko Kobayashi 2 , Masakuni Kobayashi 1 , Masayuki Kato 1 , Kazuki Sumiyama 1 , Hirobumi Toyoizumi 1 , Tomohiro Kato 1 , Shinichi Hirooka 3 , Masahiro Ikegami 3 , Hisao Tajiri 1,2 1Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan 3Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan Keyword: 食道表在癌 , 日本食道学会分類 , 拡大内視鏡 , NBI , 深達度診断 pp.153-163
Published Date 2014/2/25
DOI https://doi.org/10.11477/mf.1403114067
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 The classification for magnifying endoscopic diagnosis of SESCC(superficial esophageal squamous cell carcinoma)has been newly proposed by the Japan Esophageal Society. The classification was basically established based on Inoue's and Arima's classifications. The concepts of this classification are unification of Inoue's and Arima's classification and simplification of magnifying endoscopic diagnosis of SESCC. Type B1 is defined as loop-like microvessels with the four morphological changes in IPCLs(intra papillary capillary loops), as follows, dilatation, tortuosity, caliber change in each IPCL, and variability of shapes in multiple IPCLs. Type B1 is considered a key abnormal microvessel, which is a proposed sign of SCC(squamous cell carcinoma)invasion depth of T1a-EP and T1a-LPM. We studied the diagnostic performance of Type B1 by enlisting three endoscopists for review using NBI(narrow-band imaging)magnifying endoscopic images of 249 lesions, which were all resected endoscopically. We compared the endoscopist's review results with histology from endoscopic resection. The sensitivity and PPV(positive predictive value)of Type B microvessels in the diagnosis of SESCC were 97.6% and 99.0%, respectively. The sensitivity and PPV of Type B1 microvessel for pT1a-EP or pT1a-LPM SCC were 91.7% and 88.5%, respectively. The diagnostic performance of Type B and B1 microvessels was sufficiently strong for SCC and T1a-EP and T1a-LPM SCC, respectively. The newly proposed the Japan esophageal society classification seems to be reliable and useful for endoscopic detection of SCC and staging of T1a-EP and T1a-LPM SCC in the esophagus.

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