Esophagus最新文献

{"title":"p53 and Ki-67 combined with periodic acid-Schiff staining for the diagnosis of early stage esophageal squamous cell carcinoma lesions in biopsy specimens.","authors":"Feifei Liu, Hongying Zhao, Xue Li","doi":"10.1007/s10388-024-01102-7","DOIUrl":"10.1007/s10388-024-01102-7","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer is highly prevalent in China, predominantly represented by squamous cell carcinoma. This retrospective study sought to evaluate the diagnostic efficacy of four staining protocols in identifying early stage esophageal squamous cell carcinoma (ESCC).</p><p><strong>Methods: </strong>A consecutive series of ninety biopsy samples of esophageal mucosa, collected retrospectively from March 2016 to December 2019, were obtained at Beijing Chao-Yang Hospital, a tertiary care facility in Beijing, China. These samples were categorized into four groups: non-neoplastic squamous lesions (Non-NSL), low-grade dysplasia (LGD), high-grade dysplasia (HGD), and early stage ESCC. Baseline, molecular analyses (p53 by immunohistochemistry and Ki-67 by immunohistochemistry), and staining analyses (hematoxylin & eosin (HE) and periodic acid-Schiff (PAS) were conducted across the categories. The staining protocols included HE, HE + p53 + Ki-67, HE + p53 + Ki-67 + PAS, and HE + p53/PAS + Ki-67/PAS.</p><p><strong>Results: </strong>Patients with HGD and ESCC were significantly older and had larger lesions. Elevated p53 and Ki-67 mutation rates were observed in HGD and ESCC, while increased PAS positivity was noted in RE and LGD. The p53, Ki-67, and PAS staining results showed mostly no correlation among the four groups. Abnormal Ki-67 basal layer distribution pattern correlated with histological grades, with higher proportions in HGD and ESCC. HE + p53 + Ki-67 + PAS and HE + p53/PAS + Ki-67/PAS demonstrated complete consistency with the reference standard, with weighted κ values of 1. HE + p53 + Ki-67 + PAS and HE + p53/PAS + Ki-67/PAS protocols exhibited 100% accuracy, sensitivity, and specificity for diagnosing ESCC or ESCC combined with HGD, outperforming the other protocols.</p><p><strong>Conclusions: </strong>Incorporating specific staining protocols, particularly HE + p53 + Ki-67 + PAS and HE + p53/PAS + Ki-67/PAS, enhances the diagnostic accuracy for early stage ESCC, showing promise in advancing the pathology diagnostic pathway.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"228-238"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the synergistic effects of immunochemotherapy in esophageal squamous cell carcinoma.","authors":"Jun Okui, Kengo Nagashima, Satoru Matsuda, Yasunori Sato, Hirofumi Kawakubo, Masashi Takeuchi, Kenro Hirata, Shun Yamamoto, Motoo Nomura, Takahiro Tsushima, Hiroya Takeuchi, Ken Kato, Yuko Kitagawa","doi":"10.1007/s10388-025-01113-y","DOIUrl":"10.1007/s10388-025-01113-y","url":null,"abstract":"<p><strong>Background: </strong>Although combinations of immune-checkpoint inhibitors (ICI) with chemotherapy have been approved for esophageal squamous cell carcinoma (ESCC), it remains unclear whether immunochemotherapy (ICT) offers advantages over the simple addition of individual monotherapies. This study aimed to investigate whether ICT exhibits a synergistic effect in patients with advanced ESCC.</p><p><strong>Methods: </strong>Reconstructed individual patient data of 3330 patients were electronically extracted from the Kaplan-Meier (KM) curves of eight randomized-controlled trials (ATTRACTION-3, CheckMate648, KEYNOTE-181, KEYNOTE-590, RATIONALE-302, RATIONALE-306, ESCORT, and ESCORT-1st). The observed progression-free survival (PFS) curve of each constituent monotherapies was used to estimate simulated PFS curves expected under a model of independent drug action. If the observed curve demonstrated significantly better PFS than the simulated curve, the combination of ICI and chemotherapy may have a synergistic effect, implying a superior outcome compared to simply adding the component monotherapy.</p><p><strong>Results: </strong>The 1-year, 2-year, and median PFS of the observed and simulated KM curves were 26.3% vs. 24.8%, 14.6% vs. 12.0%, and 6.9 vs. 6.4 months, respectively. The one-sample log-rank test showed no significant differences between the observed and simulated KM curves (p = 0.073).</p><p><strong>Conclusions: </strong>The observed PFS with ICT was comparable to the simulated PFS estimated from the data for each monotherapy. Although it is unclear whether potential synergies exist for ICT, these findings suggest that the benefits of ICI and chemotherapy do not interfere with each other, thereby providing theoretical support for the efficacy of ICT.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"188-197"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of endoscopic submucosal dissection for superficial cancer of the remnant esophagus after esophagectomy.","authors":"Yoshiki Tsujii, Yoshito Hayashi, Ryotaro Uema, Hirotsugu Saiki, Eiji Kimura, Kentaro Nakagawa, Hiromu Fukuda, Ayaka Tajiri, Yujiro Adachi, Takeo Yoshihara, Takanori Inoue, Minoru Kato, Shunsuke Yoshii, Motoyuki Suzuki, Tomoki Makino, Tetsuo Takehara","doi":"10.1007/s10388-024-01100-9","DOIUrl":"10.1007/s10388-024-01100-9","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic treatment for second primary malignancies after esophagectomy has been increasingly performed; however, evidence regarding the outcomes of endoscopic submucosal dissection (ESD) for superficial cancer of the remnant esophagus after esophagectomy (SCREE) is limited.</p><p><strong>Methods: </strong>We retrospectively extracted cases of ESD for SCREE from our institutional database, which included 739 consecutive esophageal ESD procedures performed between January 2009 and September 2023. Information on prior treatment, clinical features of the lesions, and outcomes was evaluated.</p><p><strong>Results: </strong>Overall, 20 patients (median age: 74 years) with 27 lesions were enrolled. ESD was performed at a median of 15 months after esophagectomy. All lesions were flat, with a median tumor diameter of 12 mm. The median ESD procedure time was 70 min. En bloc resection was achieved for all 27 lesions, with one minor perforation complication. The R0 resection rate was 96% (26 of 27). Endoscopic balloon dilation (EBD) of the anastomotic site at the beginning of ESD was required in 30% (8 of 27) of the cases. Among them, EBD was significantly more frequently performed in cases after partial esophagectomy (64%, 7 of 11) than in cases after other types of surgery. The resection speed was significantly faster in lesions after total pharyngo-laryngo-esophagectomy and slower in lesions after subtotal esophagectomy, located in the upper region, and near the anastomosis.</p><p><strong>Conclusions: </strong>Our study demonstrated the feasibility of ESD for SCREE although EBD or a longer procedure duration may be required depending on the pre-ESD surgical technique and location of the lesions.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"148-156"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between accelerometer-measured light-intensity physical activity and tumor regression for male patients with esophageal cancer receiving neoadjuvant therapy: a retrospective cohort study.","authors":"Tomohiro Ikeda, Kazuhiro Noma, Masanori Konuma, Naoaki Maeda, Shunsuke Tanabe, Takayoshi Kawabata, Masashi Kanai, Masanori Hamada, Toshiyoshi Fujiwara, Toshifumi Ozaki","doi":"10.1007/s10388-025-01108-9","DOIUrl":"10.1007/s10388-025-01108-9","url":null,"abstract":"<p><strong>Background: </strong>Physical activity has the potential to promote tumor regression in patients with esophageal cancer receiving neoadjuvant chemotherapy (NAC); however, the benefits of light-intensity physical activity (LIPA) are unclear. This study aimed to investigate the impact of LIPA on tumor regression in male patients with esophageal cancer during NAC and its optimal cutoff value.</p><p><strong>Methods: </strong>This retrospective single-center observational study included all male patients who underwent NAC or curative esophagectomy. We assessed the physical activity of patients using an accelerometer and calculated the time spent on LIPA. Tumor regression was defined as grade ≥ 1b according to the Japanese classification of esophageal cancer. The impact of LIPA on tumor regression was analyzed using multivariate analysis, and the optimal cutoff value was identified using the receiver operating characteristic curve.</p><p><strong>Results: </strong>Sixty-nine male patients with esophageal cancer who underwent NAC were analyzed. The mean age was 68 years, mean body mass index was 22.4, and 80% of the patients were diagnosed with clinical stage 3 or 4 disease. Every extra 30-min increase in LIPA during the treatment phase was associated with tumor regression (adjusted OR 1.41 [1.02-2.04]). The optimal cutoff value of LIPA was 156.11 min/day, and patients with rich LIPA (≥ 156.11 min/day) were less likely to suffer from anorexia and malnutrition during NAC.</p><p><strong>Conclusion: </strong>This study demonstrated that LIPA during NAC has a potential of promoting tumor regression with a cutoff value of 156.5 min/day. Further clinical research is required to determine the prognostic benefits of LIPA in patients receiving NAC.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"177-187"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a novel small-caliber therapeutic endoscope in peroral endoscopic myotomy for esophageal motility disorders: a propensity score matching analysis.","authors":"Hirofumi Abe, Shinwa Tanaka, Hiroya Sakaguchi, Chise Ueda, Masato Kinoshita, Hitomi Hori, Tatsuya Nakai, Tetsuya Yoshizaki, Shinya Hoki, Hiroshi Tanabe, Satoshi Urakami, Takashi Toyonaga, Yuzo Kodama","doi":"10.1007/s10388-025-01107-w","DOIUrl":"10.1007/s10388-025-01107-w","url":null,"abstract":"<p><strong>Background: </strong>EG-840TP is a novel small-caliber therapeutic endoscope with a large working channel. We aimed to evaluate the treatment outcomes of peroral endoscopic myotomy using EG-840TP compared to those using a conventional therapeutic endoscope (GIF-H290T).</p><p><strong>Methods: </strong>Patients who underwent peroral endoscopic myotomy for achalasia and non-achalasia esophageal motility disorders were enrolled between March 2021 and March 2023. Procedure times and other treatment outcomes were compared between patients treated with EG-840TP and GIF-H290T using propensity score matching analysis. In the subgroup analysis, patients were divided into subsets based on myotomy length, morphology, esophageal dilation, and operator skill, and the procedure time was compared between the matched groups.</p><p><strong>Results: </strong>A total of 154 patients were enrolled in this study, and 39 patients treated using each type of scope were matched. The EG-840TP group tended to have a shorter procedure time than the GIF-H290T group. There were no significant differences between the groups in terms of short-term clinical success or perioperative adverse events. In the subgroup analysis, the procedure time of the EG-840TP group was significantly shorter than that of the GIF-H290T group when patients had a straight esophagus (44 min vs. 54 min, p = 0.0015) and the operator was a non-expert (49 min vs. 64 min, p = 0.031).</p><p><strong>Conclusions: </strong>POEM using EG-840TP showed procedure time, clinical success, and adverse events equivalent to those of a conventional therapeutic endoscope. However, EG-840TP potentially contributed to a shorter procedure time in patients with a straight esophagus or in non-expert operators than GIF-H290T.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"264-271"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circ_DLG1 facilitates cell proliferation and metastasis of esophageal squamous cell carcinoma via upregulating MAP3K9.","authors":"Huilin Wang, Yafan Wu, Yi Yang, Yao Pang, Hongxia Hu, Yunjiu Gou","doi":"10.1007/s10388-025-01115-w","DOIUrl":"10.1007/s10388-025-01115-w","url":null,"abstract":"<p><strong>Background: </strong>Circ_DLG1 is found to be aberrantly expressed in esophageal squamous cell carcinoma (ESCC) tissues, but its role in the progression of ESCC remains to be elucidated.</p><p><strong>Methods: </strong>The expression of circ_DLG1, miR-338-3p and mitogen-activated protein kinase kinase kinase 9 (MAP3K9) was measured by qRT-PCR. Cell cycle, viability, migration and invasion were investigated using flow cytometry, MTT assay and transwell assay, respectively. The protein levels of MAP3K9, p38, phosphor p38 (p-p38), ERK1/2 (ERKs), phosphor ERKs (p-ERKs) were detected by western blot. Dual-luciferase reporter assay and RIP assay were performed to verify the putative relationship between miR-338-3p and circ_DLG1 or MAP3K9. Animal experiments were performed to ascertain the role of circ_DLG1 in vivo.</p><p><strong>Results: </strong>Circ_DLG1 expression was elevated in ESCC tissues, plasma and cells. Circ_DLG1 knockdown inhibited cell proliferation, migration and invasion. MAP3K9 was highly expressed in ESCC, and its overexpression rescued the effects of circ_DLG1 knockdown on cell proliferation and metastasis. Besides, circ_DLG1 positively regulated MAP3K9 expression by competitively targeting miR-338-3p. Also, miR-338-3p inhibition or MAP3K9 overexpression recovered the inhibiting effect of circ_DLG1 knockdown on the phosphorylated levels of p38 and ERKs. In addition, circ_DLG1 knockdown blocked the tumor growth in vivo by regulating the miR-338-3p/MAP3K9 axis.</p><p><strong>Conclusion: </strong>Circ_DLG1 promoted malignant progression of ESCC by mediating the miR-338-3p/MAP3K9/p38/ERK pathway, indicating that targeted inhibition of the circ_DLG1/miR-338-3p/MAP3K9/p38/ERK axis might be an effective strategy for the treatment of ESCC.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"250-263"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal deep-learning model using pre-treatment endoscopic images and clinical information to predict efficacy of neoadjuvant chemotherapy in esophageal squamous cell carcinoma.","authors":"Takuma Miura, Takumi Yashima, Eichi Takaya, Yusuke Taniyama, Chiaki Sato, Hiroshi Okamoto, Yohei Ozawa, Hirotaka Ishida, Michiaki Unno, Takuya Ueda, Takashi Kamei","doi":"10.1007/s10388-025-01106-x","DOIUrl":"10.1007/s10388-025-01106-x","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy is standard for advanced esophageal squamous cell carcinoma, though often ineffective. Therefore, predicting the response to chemotherapy before treatment is desirable. However, there is currently no established method for predicting response to neoadjuvant chemotherapy. This study aims to build a deep-learning model to predict the response of esophageal squamous cell carcinoma to preoperative chemotherapy by utilizing multimodal data integrating esophageal endoscopic images and clinical information.</p><p><strong>Methods: </strong>170 patients with locally advanced esophageal squamous cell carcinoma were retrospectively studied, and endoscopic images and clinical information before neoadjuvant chemotherapy were collected. Endoscopic images alone and endoscopic images plus clinical information were each analyzed with a deep-learning model based on ResNet50. The clinical information alone was analyzed using logistic regression machine learning models, and the area under a receiver operating characteristic curve was calculated to compare the accuracy of each model. Gradient-weighted Class Activation Mapping was used on the endoscopic images to analyze the trend of the regions of interest in this model.</p><p><strong>Results: </strong>The area under the curve by clinical information alone, endoscopy alone, and both combined were 0.64, 0.55, and 0.77, respectively. The endoscopic image plus clinical information group was statistically more significant than the other models. This model focused more on the tumor when trained with clinical information.</p><p><strong>Conclusions: </strong>The deep-learning model developed suggests that gastrointestinal endoscopic imaging, in combination with other clinical information, has the potential to predict the efficacy of neoadjuvant chemotherapy in locally advanced esophageal squamous cell carcinoma before treatment.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"207-214"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term efficacy of on-demand vonoprazan treatment for mild reflux esophagitis: success rates and predictors of treatment failure.","authors":"Yoshimasa Hoshikawa, Mai Koeda, Takahiro Rokugo, Eri Momma, Noriyuki Kawami, Katsuhiko Iwakiri","doi":"10.1007/s10388-024-01099-z","DOIUrl":"10.1007/s10388-024-01099-z","url":null,"abstract":"<p><strong>Background: </strong>Concerns surrounding long-term proton pump inhibitor use have prompted the exploration of alternative treatments for reflux esophagitis (RE). We previously demonstrated that 24 weeks of on-demand treatment with vonoprazan, a potassium-competitive acid blocker, effectively managed mild RE (Los Angeles classification grade A/B) in more than 80% of patients. However, its long-term efficacy remains unknown. Therefore, the present study investigated sustained effectiveness.</p><p><strong>Methods: </strong>We conducted a retrospective observational study on 30 participants with mild RE from our previous research. Participants with recurrent RE or symptom exacerbation were excluded and considered as treatment failure. Participants with the remission of RE and reflux symptoms under on-demand treatment until the clinic visit between October 2023 and February 2024 were regarded as treatment success. Predictors of treatment failure were analyzed.</p><p><strong>Results: </strong>During the observation period, 5 participants failed treatment due to symptom exacerbation and 6 due to recurrent RE. Five participants were excluded from analyses due to non-GERD causes. Fourteen participants (56.0%) successfully continued on-demand treatment for 91.5 months [89.3-92.8]. Age > 67 years significantly predicted treatment failure with a sensitivity of 72.7% and specificity of 85.7%. Although none of the patients with RE grade A had recurrent RE, it was not a significant difference.</p><p><strong>Conclusions: </strong>Approximately 50% of patients with mild RE successfully continued on-demand treatment for more than 7 years. Age > 67 years was identified as a predictor of treatment failure. Prospective multi-center studies are warranted to validate these results.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"272-277"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional management during chemotherapy and chemoradiotherapy for advanced esophageal cancer.","authors":"Yutaka Kimura, Atsushi Gakuhara, Shuichi Fukuda, Yasunari Fukuda, Terukazu Yoshihara, Chikato Koga, Naotsugu Haraguchi, Jin-Ichi Hida","doi":"10.1007/s10388-025-01117-8","DOIUrl":"https://doi.org/10.1007/s10388-025-01117-8","url":null,"abstract":"<p><p>Advanced esophageal cancer is treated by chemotherapy, radiation therapy, chemoradiotherapy, and immunotherapy. However, the stenosis caused by the tumor and cancer-related chronic inflammation leads to inadequate food intake, weight loss, and nutrition problems. Given that poor pre-treatment nutritional status increases the risks of treatment-related adverse events and a poor prognosis, the nutrition guidelines recommend a pre-treatment nutritional assessment. When malnutrition is present, nutritional interventions, such as dietary guidance and enteral nutrition supplements, provided by the medical team may reduce treatment-related adverse events. However, whether nutritional intervention improves the prognosis is a topic for future research, including randomized controlled trials. This review discusses the literature on nutritional management in patients undergoing chemotherapy and chemoradiotherapy for advanced esophageal cancer.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The usefulness of combining narrow-band imaging with magnifying endoscopy and 18F-fluorodeoxyglucose positron emission tomography for predicting the depth of invasion in superficial esophageal squamous cell carcinoma.","authors":"So Kodama, Kenta Watanabe, Tamotsu Matsuhashi, Sho Fukuda, Yosuke Shimodaira, Yushi Nagaki, Akiyuki Wakita, Yusuke Sato, Tomoki Tozawa, Yuki Wada, Naoko Mori, Hiroshi Nanjo, Katsunori Iijima","doi":"10.1007/s10388-025-01118-7","DOIUrl":"https://doi.org/10.1007/s10388-025-01118-7","url":null,"abstract":"<p><strong>Background: </strong>To ascertain the indication of endoscopic resection (ER) for esophageal squamous cell carcinoma (ESCC), accurate preoperative diagnosis of the tumor depth beyond cT1b-SM2 is crucial. This study aimed to assess the efficacy of the combined approach utilizing narrow-band imaging with magnifying endoscopy (NBI-ME) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for accurate discrimination of lesions of pT1b-SM2 or deeper.</p><p><strong>Methods: </strong>Between 2016 and 2023, we retrospectively enrolled 127 cases (137 lesions) of superficial, treatment-naïve ESCC at Akita University Hospital, involving patients who underwent either ER alone or surgery alone. All patients underwent preoperative NBI-ME and FDG-PET. Preoperative tumor depth was estimated using type B vessels based on NBI-ME and SUVmax based on FDG-PET, and we confirmed the final tumor depth through histopathological evaluation of resected samples. The diagnostic performance of the tests in discriminating pT1b-SM2 or deeper was evaluated in terms of sensitivity, specificity, and accuracy.</p><p><strong>Results: </strong>Treatment consisted of ER in 97 lesions and surgery in the remaining 40. Fifty-three lesions (44.7%) had pT1b-SM2 or deeper invasion. The sensitivity, specificity, and accuracy of NBI-ME using type B3 vessels were 41.5%, 97.6%, and 75.9%, respectively. For FDG-PET with a cutoff SUVmax of ≥ 2.4, these were 79.2%, 69.0%, and 73.0%, respectively. Combining both tests substantially improved diagnostic performance, with sensitivity, specificity, and accuracy of 83.0%, 89.3%, and 86.9%, respectively.</p><p><strong>Conclusion: </strong>The combination of FDG-PET and NBI-ME offers enhanced diagnostic performance for ESCC with ≥ pT1b-SM2, thereby facilitating a more efficacious preoperative narrowing of the indications for ER of superficial ESCC.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}