Diagnosis of Invasion Depth of Superficial Barrett's Esophageal Adenocarcinoma Yuki Maeda 1 , Dai Hirasawa 1 , Yoshihiro Harada 1 , Tetsuya Ohira 1 , Taku Yamagata 1 , Kenjirou Suzuki 1 , Yoshiki Koike 1 , Megumi Tanaka 1 , Yutaka Noda 1 1Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan Keyword: Barrett食道癌 , Barrett's esophageal cancer , 深達度診断 pp.575-582
Published Date 2015/5/24
DOI https://doi.org/10.11477/mf.1403200284
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 The diagnosis of the invasion depth of superficial Barrett's esophageal adenocarcinoma is important for the determination of therapeutic strategy because the invasion depth markedly correlates with lymph node metastasis. WLI(white-light imaging), magnifying IEE(imaging with image enhanced endoscopy), EUS(endoscopic ultrasonography), and X-ray are used for diagnosing the invasion depth ; of these, WLI is the most important modality that is used to observe the shape, size, thickness, hardness, and color change. Fat 0-IIb and 0-IIa lesions, 0-I lesions with a narrow base, and 0-IIc lesions with a flat, smooth depression indicate mucosal cancer. Furthermore, IEE using acetic acid is useful in diagnosing the lateral extent of the lesions. Barrett's esophageal adenocarcinoma occurring from short-segment Barrett's esophagus, which constitutes the majority of Barrett's adenocarcinoma cases in Japan, is often difficult to closely examine by EUS and X-ray because of its location at the esophagogastric junction.

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