Significance of AVA for Prediction of Infiltration Depth of Esophageal Cancer Ryu Ishihara 1 , Kenji Aoi 1 , Noriko Matsuura 1 , Takashi Ito 1 , Takeshi Yamashina 1 , Sachiko Yamamoto 1 , Noboru Hanaoka 1 , Yoji Takeuchi 1 , Koji Higashino 1 , Noriya Uedo 1 , Hiroyasu Iishi 1 , Masaharu Tatsuta 1 , Yasuhiko Tomita 2 , Shingo Ishiguro 3 1Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan 2Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan 3PCL Osaka Pathology & Cytology Center, Ibaraki, Japan Keyword: AVA , avascular area , 日本食道学会分類 , 食道癌 , NBI , 拡大内視鏡 pp.204-211
Published Date 2014/2/25
DOI https://doi.org/10.11477/mf.1403114074
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 A new endoscopic classification, the Japan Esophageal Society classification, has been developed. In this classification, AVA(avascular area)is defined as an area with low vascularity surrounded by type B vessels. We investigated the significance of AVA in patients with esophageal cancer treated by endoscopic resection in our department. AVA was observed in 8.4%(46/547 lesions)of lesions. Diagnostic accuracy of cancer invasion depth using AVA was 80.6%(25/31 lesions)in pathological T1a-EP/LPM cancers, 76.9%(10/13 lesions)in pathological T1a-MM/T1b-SM1 cancers, 50.0%(1/2 lesions)in pathological T1b-SM2 cancers. Characterizing the vessels surrounding AVA was the important point for accurate diagnosis. Accurate diagnosis was difficult when cancer was invading in a small area or when the structure of intraepithelial cancer was not destroyed by cancer invasion.

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