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The Japan Esophageal Society classification system for the diagnosis of Barrett's esophageal lesions using magnifying endoscopy
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R. Ishihara1,
K. Goda2,
T. Oyama3 |
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1Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 2Digestive Disease Center, Showa University Koto Toyosu Hospital, 3Department of Endoscopy, Saku Central Hospital Advanced Care Center |
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| A new classification (Japan Esophageal Society [JES] classification) for the diagnosis of Barrett's esophagus (BE) -related lesions by magnifying endoscopy was developed. In this classification, diagnosis of dysplastic lesion is made by the irregularity of surface and vascular patterns. A multicenter study was conducted to confirm the validity of the classification. We collected 156 images (67 non-dysplastic and 89 dysplastic BE) taken by NBI with high-definition magnifying endoscopy. Ten endoscopists (five experts and five non-experts) were recruited from 10 hospital as reviewers and were given a lecture on the JES classification. Then, they reviewed the images twice, immediately after the lecture (1st test) and 6 weeks after (2nd test). Sensitivity, specificity, and overall accuracy of the JES classification system in the diagnosis of dysplastic BE were 87%, 98%, and 91% for experts and 87%, 97%, and 91% for non-experts, respectively. Inter-observer agreement was substantial among the experts (κ = 0.75) and non-experts (κ = 0.79) on the 1st test. Intra-observer agreement of experts and non-experts between the 1st and 2nd tests were almost perfect (κ = 0.83 and 0.83, respectively). Our results suggest that the JES classification may provide high accuracy and reproducibility in the diagnosis of BE-related superficial neoplasms. |
Index Term 1: Esophageal cancer
Index Term 2: Magnifying endoscopy |
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