Comparison of staging diagnosis by two magnifying endoscopy classification for superficial oesophageal cancer.
BACKGROUND
Due to the possibility of lymph node metastasis, surgical resection is indicated for superficial oesophageal cancer with invasion to a depth greater than the muscularis mucosa. Although two magnifying endoscopy classifications are currently used to diagnose the depth of invasion, which classification is more suitable remains controversial.


OBJECTIVE
To compare and evaluate the clinical outcomes of two classifications for superficial oesophageal squamous cell carcinoma.


METHODS
This cross-sectional study consists of 44 superficial oesophageal squamous cell carcinoma lesions with magnification image-enhanced endoscopy images. Only magnifying endoscopic images were displayed to two experienced endoscopists who independently diagnosed the depth of invasion according to both classifications.


RESULTS
The sensitivity of invasion greater than the muscularis mucosa tended to be higher in Inoue's classification than Arima's classification (78.3±6.2% vs. 50.0±3.0%; P=0.144), whereas the specificity was significantly lower in Inoue's classification than in Arima's classification (61.9±0.0% vs. 97.6±3.4%; P=0.043). For both classifications, rates of concordance were 90.9% and 84.4%, and κ statistics were 0.81 and 0.66, respectively.


CONCLUSIONS
Our results suggest that Arima's classification is suitable for general screening before treatment to avoid unnecessary surgery. Inoue's classification is appropriate for assessing wide lesion.
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan.
Masahide
M
Ebi
Takaya
T
Shimura
Kenji
K
Murakami
Tomonori
T
Yamada
Yoshikazu
Y
Hirata
Hironobu
H
Tsukamoto
Tsutomu
T
Mizoshita
Satoshi
S
Tanida
Hiromi
H
Kataoka
Takeshi
T
Kamiya
Takashi
T
Joh
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002965:Classification / Q000379:methods*; D003430:Cross-Sectional Studies; D004938:Esophageal Neoplasms / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity