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International Session (Panel Discussion)1 (JGES・JSGE・JSGS)
Sat. October 14th   9:00 - 11:20   Room 11: Fukuoka International Congress Center 502+503
Objective endoscopic findings of depth indicating for superficial Barrett's adenocarcinoma
S. Yoshinaga1, I. Oda1, H. Taniguchi2
1Endoscopy Division, National Cancer Center Hospital, 2Pathology Division, National Cancer Center Hospital
(Introduction and Aim) Although the depth of invasion is the important factor to make a decision in treatment, little is known about the correlation between endoscopic feature and invasion depth of superficial Barrett's adenocarcinoma (SBA). We aimed to investigate the endoscopic findings indicating deep submucosal invasion (SM2) of SBA. (Patients and Methods) This study included 59 SBAs in 57 patients confined to mucosa or submucosa between 2008 and 2015. Four expert endoscopists who were blinded to histology independently reviewed the endoscopic images. According to previous studies, they selected macroscopic type, estimated lesion size, and determine present or absent of remarkable redness, uneven surface, margin elevation, ulceration, and enlarged folds. If more than 3 of 4 endoscopists pointed out, such finding was defined as the positive finding. Then, we evaluated the relationship between positive findings and SM2. Additionally, we evaluated the concordance rates of endoscopic findings among endoscopists.(Results) Fifteen lesions invaded SM2 (25.4%). Estimated tumor size (more than 21mm) (14.0% in M-SM1 vs 56.3% in SM2), remarkable redness (20.8% vs 66.7%), uneven surface (13.7% vs 100%) and margin elevation (20.4% vs 80.0%) were significantly more common in SM2. In these 4 endoscopic findings, Kendall's W values, which indicate the concordance, are 0.761, 0.548, 0.621 and 0.467 respectively.(Conclusion) Estimated tumor size, remarkable redness and uneven surface might be helpful endoscopic features to predict SM2 in patients with SBA.
Index Term 1: Barrett's adenocarcinoma
Index Term 2: Endoscopic diagnosis
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