MAGNIFYING ENDOSCOPIC OBSERVATION OF SUPERFICIAL ESOPHAGEAL CARCINOMA

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Abstract

The depth of tumor invasion of esophageal cancers is one of the most important indicators for predicting lymph node metastasis, so much effort has been directed toward improving the diagnosis of tumor invasion, especially in cases of superficial esophageal cancer. Ultra-high magnifying endoscopic observation for esophageal cancer was performed using an Olympus Q240Z, which has a 100 × magnifying capacity. We succeeded in observing looped capillary vessels inside the papillae (intrapapillary capillary loop: IPCL). The IPCL inside an m1 cancer showed abnormal changes such as ‘dilation, weaving, changes in caliber, variety of shapes’. Furthermore, we found that superficial esophageal cancers show characteristic changes according to the depth of invasion. In our investigation, the rate of accurate diagnosis using magnifying endoscopy for superficial esophageal cancers was 83.1% in cases for which fine pictures were obtained. Observations of the microvascular architecture of superficial esophageal carcinoma using magnifying endoscopy are useful for diagnosing the depth of tumor invasion, especially for superficial cancers with invasion reaching to the muscularis mucosae (m3) and slightly into the submucosa (sm1) esophageal cancer.

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