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Review
. 2022 Aug 5;52(8):799-805.
doi: 10.1093/jjco/hyac064.

Current status of endoscopic detection, characterization and staging of superficial esophageal squamous cell carcinoma

Ryu Ishihara  1 , Manabu Muto  2
Affiliations
Review

Current status of endoscopic detection, characterization and staging of superficial esophageal squamous cell carcinoma

Ryu Ishihara et al. Jpn J Clin Oncol. .

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Jpn J Clin Oncol. 2022 Nov 3;52(11):1358. doi: 10.1093/jjco/hyac156. Jpn J Clin Oncol. 2022. PMID: 36124846 Free PMC article. No abstract available.

Abstract

Background: This review focuses on the current status of endoscopic detection, characterization and tumour category staging of oesophagealsquamous cell carcinoma.

Detection: The diagnostic yield of white-light imaging is limited and narrow-band imaging has demonstrated a better performance for detecting oesophageal cancer. Narrow-band imaging has also shown similar sensitivity and superior specificity to iodine staining.

Characterization: Accurate differentiation between cancerous and non-cancerous lesions can be achieved by magnifying narrow-band imaging or iodine staining with confirmation of a pink-colour sign. A per-patient analysis of a randomized study showed similar sensitivities, specificities and overall accuracies of magnifying narrow-band imaging and iodine staining of 82.2%, 95.1% and 91.2%, and 80.5%, 94.3% and 90.5%, respectively.

Tumour-staging: The diagnostic capability of endoscopic ultrasonography after conventional and narrow-band imaging in terms of tumour depth was evaluated in a multicentre prospective study. Endoscopic ultrasonography did not significantly improve the accuracy for distinguishing between mucosal or submucosal microinvasive cancer and deeper cancers from 72.9 to 74.0%, suggesting that additional endoscopic ultrasonography did not improve the diagnostic accuracy. In addition, endoscopic ultrasonography increased the incidence of overdiagnosis, defined as a diagnosis of cancer depth greater than the actual depth, by 6.6%. The risk of overdiagnosis by endoscopic ultrasonography was reconfirmed in two systematic reviews.

Conclusions: Narrow-band imaging is currently considered as the standard modality for the detection and characterization of oesophageal cancer. The risk of overdiagnosis should be considered when applying endoscopic ultrasonography for the evaluation of tumour invasion depth of superficial oesophageal squamous cell carcinoma.

Keywords: endoscopic diagnosis; endoscopic ultrasonography; magnifying endoscopy; narrow-band imaging; oesophageal cancer.

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