Background Coloration of Squamous Epithelium in Esophago-Pharyngeal Squamous Cell Carcinoma: What Causes the Color Change?

Minami, Hitomi; Isomoto, Hajime; Nakayama, Toshiyuki; Hayashi, Tomayoshi; Yamaguchi, Naoyuki; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro

doi:10.1371/journal.pone.0085553

Cited by 7 publications

(6 citation statements)

References 17 publications

(24 reference statements)

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“…Minami et al . reported the presence of extravascular Hb components in esophageal squamous cell carcinoma, and further reported that the anti‐Hb Ab‐positive area was perfectly matched to the cancer area, while the surrounding noncancerous epithelium was negative for Hb staining 12 . However, our study showed positive Hb staining within the epithelium despite the noncancerous lesions, which suggests that the Hb component in the esophageal epithelium may not be a cancer‐specific change (Fig.…”

Section: Discussionsupporting

confidence: 58%

Beige mucosa observable under narrow‐band imaging indicates the active sites of eosinophilic esophagitis

Ayaki

Manabe

Tomida³

et al. 2022

J of Gastro and Hepatol

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Background and Aim The majority of patients with eosinophilic esophagitis (EoE) are likely to have observable features under narrow‐band imaging, namely beige mucosa. However, the histological features and clinical implications of beige mucosa have not been investigated. The aim of this study was to determine whether beige mucosa could serve as an endoscopic marker for predicting active inflammatory sites of EoE. Methods We retrospectively analyzed both the narrow‐band images and biopsied specimens of 77 esophageal lesions from 35 consecutive patients with EoE. We divided these specimens into two groups: target biopsied specimens from beige mucosa (beige group) and specimens biopsied from non‐beige mucosa (non‐beige group). The number of eosinophils per high‐powered field, thickness of the superficial differentiated cell layer, and depth of the hemoglobin component from the surface layer were compared between the two groups. Results Forty‐four out of the 45 specimens were diagnosed as histological active lesions in the beige group. The sensitivity, specificity, and overall accuracy of beige mucosa in predicting EoE activity were 97.8%, 96.9%, and 97.8%, respectively. Compared with the non‐beige group, specimens in the beige group had a significantly thinner superficial differentiated cell layer. Conclusions Beige mucosa is associated with thinning of the normal superficial differentiated cell layer, and these histological changes in the active inflammatory sites of EoE could be recognized endoscopically as color differences. Beige mucosa may serve as an endoscopic indicator for predicting the histological activity of EoE.

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Section: Discussionsupporting

confidence: 58%

Beige mucosa observable under narrow‐band imaging indicates the active sites of eosinophilic esophagitis

Ayaki

Manabe

Tomida³

et al. 2022

J of Gastro and Hepatol

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“…Intervascular background coloration will be useful for predicting histology of HGIN and invasive SCC [ 16 , 17 ]. A recent study indicated that intervascular background coloration might be caused by an extravascular component of hemoglobin that is produced within tumor cells [ 23 ]. The other study showed that intervascular background coloration might be related to the thinning of the keratinous layer or the epithelium caused by neoplastic cell proliferation [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of the invasion depth of superficial squamous cell carcinoma based on microvessel morphology: magnifying endoscopic classification of the Japan Esophageal Society

et al. 2016

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Predicting invasion depth of superficial esophageal squamous cell carcinoma is crucial in determining the precise indication for endoscopic resection because the rate of lymph node metastasis increases in proportion to the invasion depth of the carcinoma. Previous studies have shown a close relationship between microvascular patterns observed by Narrow Band Imaging magnifying endoscopy and invasion depth of the superficial carcinoma. Thus, the Japan Esophageal Society (JES) developed a simplified magnifying endoscopic classification for estimating invasion depth of superficial esophageal squamous cell carcinomas. We conducted a prospective study to evaluate the diagnostic values of type B vessels in the pretreatment estimation of invasion depth of superficial esophageal squamous cell carcinomas utilizing JES classification, the criteria of which are based on the degree of irregularity in the microvascular morphology. Type A microvessels corresponded to noncancerous lesions and lack severe irregularity; type B, to cancerous lesions, and exhibit severe irregularity. Type B vessels were subclassified into B1, B2, and B3, diagnostic criteria for T1a-EP or T1a-LPM, T1a-MM or T1b-SM1, and T1b-SM2 tumors, respectively. We enrolled 211 patients with superficial esophageal squamous cell carcinoma. The overall accuracy of type B microvessels in estimating tumor invasion depth was 90.5 %. We propose that the newly developed JES magnifying endoscopic classification is useful in estimating the invasion depth of superficial esophageal squamous cell carcinoma.

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“…for ESCC or HGIN in previous studies (34.3-36.1%), and thinning of the keratinous layer and the thinning of epithelium, and an extravascular component of hemoglobin were reported as significant factors for brownish epithelium in NBI. 26,27 Nonneoplastic regions with such factors may have caused the low PPV in BLI ‡ Six patients, who had both lesions detected and missed by the primary mode, in the LCI group were counted as missed patients as well as detected patients.…”

Section: Discussionmentioning

confidence: 99%

Blue light imaging and linked color imaging as a screening mode for esophageal squamous cell carcinoma in high‐risk patients: Multicenter randomized trial

Ogata

Hatta

Koike

et al. 2023

Digestive Endoscopy

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ObjectivesBlue light imaging (BLI) and linked color imaging (LCI) are superior to conventional white light imaging for detecting esophageal squamous cell carcinoma (ESCC). Hence, we compared their diagnostic performances in ESCC screening.MethodsThis open‐labeled, randomized controlled trial was performed at seven hospitals. Patients with a high risk of ESCC were randomly assigned to the BLI group (BLI followed by LCI) and LCI group (LCI followed by BLI). The primary end‐point was the detection rate of ESCC in the primary mode. The main secondary end‐point was its miss rate in the primary mode.ResultsIn total, 699 patients were enrolled. The detection rate of ESCC did not significantly differ between the BLI and LCI groups (4.0% [14/351] vs. 4.9% [17/348]; P = 0.565); however, the number of patients with ESCC tended to be smaller in the BLI group (19 vs. 30). Notably, the miss rate of ESCC was lower in the BLI group (26.3% [5/19] vs. 63.3% [19/30]; P = 0.012) and LCI detected no ESCCs missed by BLI. The sensitivity was higher in BLI (75.0% vs. 47.6%; P = 0.042); on the other hand, the positive predictive value in BLI tended to be lower (28.8% vs. 45.5%; P = 0.092).ConclusionsThe detection rates of ESCC did not significantly differ between BLI and LCI. Although BLI may have the potential to be advantageous over LCI for the diagnosis of ESCC, it is still unclear whether BLI is superior to LCI, and a further large‐scale study is needed.Trial registrationJapan Registry of Clinical Trials (jRCT1022190018‐1).

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Background Coloration of Squamous Epithelium in Esophago-Pharyngeal Squamous Cell Carcinoma: What Causes the Color Change?

Cited by 7 publications

References 17 publications

Beige mucosa observable under narrow‐band imaging indicates the active sites of eosinophilic esophagitis

Beige mucosa observable under narrow‐band imaging indicates the active sites of eosinophilic esophagitis

Prediction of the invasion depth of superficial squamous cell carcinoma based on microvessel morphology: magnifying endoscopic classification of the Japan Esophageal Society

Blue light imaging and linked color imaging as a screening mode for esophageal squamous cell carcinoma in high‐risk patients: Multicenter randomized trial

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