Efficacy of acetic acid‐spraying method in diagnosing extension of barrett's cancer under the squamous epithelium

253

259

The Japan Gastroenterological Endoscopy Society has developed endoscopic submucosal dissection/endoscopic mucosal resection guidelines. These guidelines present recommendations in response to 18 clinical questions concerning the preoperative diagnosis, indications, resection methods, curability assessment, and surveillance of patients undergoing endoscopic resection for esophageal cancers based on a systematic review of the scientific literature.

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer

Ishihara

Arima

Iizuka

et al. 2020

253

259

“…However, the aims of these classifications were detection of intestinal metaplasia and neoplasia. Only a few published studies have suggested the usefulness of NBI‐ME for the diagnosis of the lateral extension of EAC in BE …”

Section: Discussionmentioning

confidence: 99%

Barrett's esophageal adenocarcinoma diagnosed by narrow‐band imaging magnifying endoscopy

Takahashi

Oyama

2013

A 40-year-old man was referred to our hospital for detailed examination of a protuberant lesion in long-segment Barrett's esophagus (LSBE). Under white light endoscopy (WLE) the lesion appeared as a protuberant lesion with a rough surface and was diagnosed as 0-IIa-type tumor suspected to be a welldifferentiated adenocarcinoma. A regular villous pattern was shown in the background mucosa of the LSBE by narrow-band imaging (NBI) magnifying endoscopy (NBI-ME). However, a slightly irregular villous pattern was observed on the lateral side of the main lesion. Therefore, a 0-IIa-type tumor was estimated to have a flatly lateral extension component (i.e. 0-IIb spreading). The 0-IIb spreading was unclear when using WLE, but could be diagnosed by NBI-ME based on the surface pattern differences. Markings were placed outside the edge of the flatly lateral extension, and endoscopic submucosal dissection was carried out.The pathological diagnosis of the protuberant lesion with flatly lateral spreading was well-differentiated adenocarcinoma. The macroscopic type was 0-IIa+IIb, 45 ¥ 43 mm in size. The invasion depth was T1a (deep muscularis mucosae). Lymphatic and venous invasions were negative; horizontal and vertical margins were negative. In conclusion, NBI-ME was useful for the diagnosis of the flatly lateral extension of this 0-IIa+IIb esophageal adenocarcinoma in Barrett's esophagus. Further investigations with many cases are necessary.

“…38,39 Fortun et al 40 also reported a targeted biopsy by acetic acid-magnifying endoscopy showing a high yield of dysplasia and, more recently, acetic acid-magnifying endoscopy enabled visualization of a subsquamous tumor extension. 41 This technique could therefore be helpful for tumor extension diagnosis prior to endoscopic resection and early detection of remnant or recurrent tumor after radiofrequency ablation therapy. 42…”

Section: Crystal Violetmentioning

confidence: 99%

Endoscopic diagnosis of early Barrett's neoplasia: Perspectives for advanced endoscopic technology

Goda

Kato

Tajiri

2014

Barrett's esophagus (BE) is a metaplastic condition that occurs secondary to gastroesophageal reflux disease. BE is also a precursor to esophageal adenocarcinoma, which, although still rare in Japan, is one of the most rapidly increasing cancers in Western countries. However, the prevalence of gastroesophageal reflux disease has increased significantly over the past few decades in Japan, possibly leading to an incremental rise in BE and the associated inherent risk of adenocarcinoma. Given the poor prognosis of advanced‐stage Barrett's adenocarcinoma, endoscopic surveillance is recommended for subjects with BE to detect early neoplasias including dysplasia. However, endoscopic identification of dysplastic lesions is still not sufficiently reliable or subjective, making targeted therapy extremely difficult. Over the past few years, improvements in image resolution, image processing software, and optical filter technology have enabled identification of dysplasia and early cancer in BE patients. We retrieved as many studies on advanced endoscopic technologies in BE as possible from MEDLINE and PubMed. The present review focuses on the emergent clinically available technologies to provide an overview of the technologies, their practical applicability, current status, and future challenges.