{"title":"食管内镜切除后在内镜监测下发现侵犯肌层或更深的食管鳞状细胞癌。","authors":"Daiki Kitagawa, Ryu Ishihara, Shunsuke Yoshii, Yuya Asada, Tomoya Ueda, Atsuko Kizawa, Takehiro Ninomiya, Yuki Okubo, Yushi Kawakami, Yasuhiro Tani, Minoru Kato, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Tomoki Michida, Yasuhiro Fujiwara","doi":"10.1007/s10388-025-01124-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Surveillance endoscopy is recommended after endoscopic resection of esophageal squamous cell carcinomas (ESCCs). However, surveillance endoscopy sometimes detects advanced subsequent ESCCs with invasion of the muscularis mucosa (MM) or deeper. We aimed to clarify the clinicopathological features of these advanced subsequent ESCCs.</p><p><strong>Methods: </strong>This single-center retrospective study identified subsequent ESCCs detected during surveillance endoscopy. ESCCs that invaded the MM or deeper and were detected within 24 months after the previous endoscopy were defined as post-endoscopy esophageal advanced lesions (PEEALs), while the first ESCC detected in the patient was defined as the primary lesion. Study 1 compared the clinicopathological characteristics of PEEALs versus non-advanced lesions. Study 2 compared the endoscopic features of pT1a-MM PEEALs versus pT1a-MM primary lesions.</p><p><strong>Results: </strong>A total of 307 subsequent ESCCs were analyzed in Study 1. Of these, 20 were PEEALs and 287 were non-advanced lesions (pT1a-EP/LPM). The median intervals from the previous endoscopy for PEEALs and non-advanced lesions were 6.1 months and 6.7 months, respectively (P = 0.283). The morphological feature of marginal elevation was seen in 60% of PEEALs. In Study 2, 15 pT1a-MM PEEALs were compared with 149 pT1a-MM primary lesions. Compared with primary lesions, pT1a-MM PEEALs were smaller (median 10 mm vs. 30 mm, P < 0.001) and had a higher prevalence of marginal elevation morphology (53.3% vs. 10.1%, P < 0.001).</p><p><strong>Conclusions: </strong>The specific feature of PEEALs was marginal elevation. Surveillance endoscopy with careful observation for these lesions is recommended after endoscopic resection of ESCCs.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Post-endoscopy esophageal squamous cell carcinoma with invasion of the muscularis mucosa or deeper detected in surveillance endoscopy after esophageal endoscopic resection.\",\"authors\":\"Daiki Kitagawa, Ryu Ishihara, Shunsuke Yoshii, Yuya Asada, Tomoya Ueda, Atsuko Kizawa, Takehiro Ninomiya, Yuki Okubo, Yushi Kawakami, Yasuhiro Tani, Minoru Kato, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Tomoki Michida, Yasuhiro Fujiwara\",\"doi\":\"10.1007/s10388-025-01124-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Surveillance endoscopy is recommended after endoscopic resection of esophageal squamous cell carcinomas (ESCCs). However, surveillance endoscopy sometimes detects advanced subsequent ESCCs with invasion of the muscularis mucosa (MM) or deeper. We aimed to clarify the clinicopathological features of these advanced subsequent ESCCs.</p><p><strong>Methods: </strong>This single-center retrospective study identified subsequent ESCCs detected during surveillance endoscopy. ESCCs that invaded the MM or deeper and were detected within 24 months after the previous endoscopy were defined as post-endoscopy esophageal advanced lesions (PEEALs), while the first ESCC detected in the patient was defined as the primary lesion. Study 1 compared the clinicopathological characteristics of PEEALs versus non-advanced lesions. Study 2 compared the endoscopic features of pT1a-MM PEEALs versus pT1a-MM primary lesions.</p><p><strong>Results: </strong>A total of 307 subsequent ESCCs were analyzed in Study 1. Of these, 20 were PEEALs and 287 were non-advanced lesions (pT1a-EP/LPM). The median intervals from the previous endoscopy for PEEALs and non-advanced lesions were 6.1 months and 6.7 months, respectively (P = 0.283). The morphological feature of marginal elevation was seen in 60% of PEEALs. In Study 2, 15 pT1a-MM PEEALs were compared with 149 pT1a-MM primary lesions. Compared with primary lesions, pT1a-MM PEEALs were smaller (median 10 mm vs. 30 mm, P < 0.001) and had a higher prevalence of marginal elevation morphology (53.3% vs. 10.1%, P < 0.001).</p><p><strong>Conclusions: </strong>The specific feature of PEEALs was marginal elevation. Surveillance endoscopy with careful observation for these lesions is recommended after endoscopic resection of ESCCs.</p>\",\"PeriodicalId\":11918,\"journal\":{\"name\":\"Esophagus\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Esophagus\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10388-025-01124-9\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Esophagus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10388-025-01124-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:内镜下食管鳞状细胞癌(ESCCs)切除术后推荐进行内镜检查。然而,监测内窥镜有时会检测到晚期escc伴有肌层粘膜(MM)或更深的侵犯。我们的目的是澄清这些晚期escc的临床病理特征。方法:这项单中心回顾性研究确定了在内镜检查中检测到的escc。侵袭MM或更深的ESCC,并在前一次内镜检查后24个月内检测到的ESCC被定义为内镜检查后食管晚期病变(PEEALs),而患者首次检测到的ESCC被定义为原发性病变。研究1比较了PEEALs与非晚期病变的临床病理特征。研究2比较了pT1a-MM PEEALs与pT1a-MM原发病变的内镜特征。结果:研究1共分析了307例escc。其中,20例为peeal, 287例为非晚期病变(pT1a-EP/LPM)。peeal和非晚期病变的中位时间间隔分别为6.1个月和6.7个月(P = 0.283)。60%的PEEALs具有边缘抬高的形态学特征。在研究2中,15例pT1a-MM peeal与149例pT1a-MM原发病变进行了比较。与原发病变相比,pT1a-MM PEEALs更小(中位数为10 mm vs 30 mm, P)。内镜下escc切除术后,建议进行内窥镜检查,仔细观察这些病变。
Post-endoscopy esophageal squamous cell carcinoma with invasion of the muscularis mucosa or deeper detected in surveillance endoscopy after esophageal endoscopic resection.
Background: Surveillance endoscopy is recommended after endoscopic resection of esophageal squamous cell carcinomas (ESCCs). However, surveillance endoscopy sometimes detects advanced subsequent ESCCs with invasion of the muscularis mucosa (MM) or deeper. We aimed to clarify the clinicopathological features of these advanced subsequent ESCCs.
Methods: This single-center retrospective study identified subsequent ESCCs detected during surveillance endoscopy. ESCCs that invaded the MM or deeper and were detected within 24 months after the previous endoscopy were defined as post-endoscopy esophageal advanced lesions (PEEALs), while the first ESCC detected in the patient was defined as the primary lesion. Study 1 compared the clinicopathological characteristics of PEEALs versus non-advanced lesions. Study 2 compared the endoscopic features of pT1a-MM PEEALs versus pT1a-MM primary lesions.
Results: A total of 307 subsequent ESCCs were analyzed in Study 1. Of these, 20 were PEEALs and 287 were non-advanced lesions (pT1a-EP/LPM). The median intervals from the previous endoscopy for PEEALs and non-advanced lesions were 6.1 months and 6.7 months, respectively (P = 0.283). The morphological feature of marginal elevation was seen in 60% of PEEALs. In Study 2, 15 pT1a-MM PEEALs were compared with 149 pT1a-MM primary lesions. Compared with primary lesions, pT1a-MM PEEALs were smaller (median 10 mm vs. 30 mm, P < 0.001) and had a higher prevalence of marginal elevation morphology (53.3% vs. 10.1%, P < 0.001).
Conclusions: The specific feature of PEEALs was marginal elevation. Surveillance endoscopy with careful observation for these lesions is recommended after endoscopic resection of ESCCs.
期刊介绍:
Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.