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13.11.2021 | Original Article

Blue laser imaging identifies endoscopic findings corresponding to metachronous esophageal squamous cell carcinoma

verfasst von: Yuka Azuma, Osamu Dohi, Yuji Naito, Takeshi Yasuda, Takuma Yoshida, Tsugitaka Ishida, Hiroaki Kitae, Shinya Matsumura, Toshihumi Doi, Ryohei Hirose, Ken Inoue, Naohisa Yoshida, Kazuhiro Kamada, Kazuhiko Uchiyama, Tomohisa Takagi, Takeshi Ishikawa, Hideyuki Konishi, Ayako Nishimura, Mitsuo Kishimoto, Yoshito Itoh

Erschienen in: Esophagus | Ausgabe 2/2022

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Abstract

Background and study aim

This study aimed to evaluate endoscopic findings using non-magnifying blue laser imaging (BLI) to determine the risk factors for metachronous esophageal squamous cell carcinoma (ESCC).

Patients and methods

All consecutive patients who underwent endoscopic submucosal dissection (ESD) for primary superficial ESCC (SESCC) without a history of ESCC between January 2013 and January 2016 were enrolled. Three highly experienced endoscopists investigated seven endoscopic findings using non-magnifying BLI as follows: (1) a brownish area with unclear margin, (2) white flat deposits, (3) multiple foci of dilated vessels, (4) low capillary permeability, (5) multiple glycogenic acanthosis, (6) horizontal lines, and (7) a nonuniform color tone. Furthermore, Lugol-voiding lesions (LVLs) were graded according to the number of LVLs per endoscopic view (A, no lesions; B, 1–9 lesions; C, ≥ 10 lesions).

Results

A total of 102 SESCC patients who underwent ESD were included. Multivariate analyses showed that multiple foci of dilated vessels, low capillary permeability, and a nonuniform color tone were significantly associated with metachronous ESCC (hazard ratio [HR] 2.30; 95% confidence interval [CI] 1.01–5.46; P = 0.049, HR 5.25; 95% CI 1.86–15.01; P = 0.002 and HR 3.17; 95% CI 1.11–9.43; P = 0.032, respectively). The three-year cumulative incidence of metachronous ESCC was significantly higher in patients with low capillary permeability and a nonuniform color tone than in patients without these findings. (41.1% vs. 6.0%, 45.0% vs. 12.7%, respectively, P < 0.001 for both).

Conclusion

BLI findings of multiple foci of dilated vessels, low capillary permeability, and a nonuniform color tone in the background esophageal mucosa were risk factors for patients with metachronous ESCC after ESD.
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Metadaten
Titel
Blue laser imaging identifies endoscopic findings corresponding to metachronous esophageal squamous cell carcinoma
verfasst von
Yuka Azuma
Osamu Dohi
Yuji Naito
Takeshi Yasuda
Takuma Yoshida
Tsugitaka Ishida
Hiroaki Kitae
Shinya Matsumura
Toshihumi Doi
Ryohei Hirose
Ken Inoue
Naohisa Yoshida
Kazuhiro Kamada
Kazuhiko Uchiyama
Tomohisa Takagi
Takeshi Ishikawa
Hideyuki Konishi
Ayako Nishimura
Mitsuo Kishimoto
Yoshito Itoh
Publikationsdatum
13.11.2021
Verlag
Springer Singapore
Erschienen in
Esophagus / Ausgabe 2/2022
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-021-00894-2

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