BMC Gastroenterology (Nov 2020)

Narrow band imaging under less-air condition improves the visibility of superficial esophageal squamous cell carcinoma

  • Taro Iwatsubo,
  • Ryu Ishihara,
  • Yasushi Yamasaki,
  • Yusuke Tonai,
  • Kenta Hamada,
  • Minoru Kato,
  • Sho Suzuki,
  • Mitsuhiro Kono,
  • Hiromu Fukuda,
  • Yusaku Shimamoto,
  • Kentaro Nakagawa,
  • Masayasu Ohmori,
  • Masamichi Arao,
  • Kenshi Matsuno,
  • Hiroyoshi Iwagami,
  • Shuntaro Inoue,
  • Hiroko Nakahira,
  • Noriko Matsuura,
  • Satoki Shichijo,
  • Akira Maekawa,
  • Takashi Kanesaka,
  • Yoji Takeuchi,
  • Koji Higashino,
  • Noriya Uedo,
  • Kazuhide Higuchi

DOI
https://doi.org/10.1186/s12876-020-01534-2
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 8

Abstract

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Abstract Background The current virtual chromoendoscopy equipment cannot completely detect superficial squamous cell carcinoma (SCC) in the esophagus, despite its development in the recent years. Thus, in this study, we aimed to elucidate the appropriate air volume during endoscopic observation to improve the visibility of esophageal SCC. Methods This retrospective study included a total of 101 flat type esophageal SCCs identified between April 2017 and January 2019 at the Department of Gastrointestinal Oncology, Osaka International Cancer Institute. Video images of narrow band imaging (NBI) under both less-air and standard-air conditions were recorded digitally. Videos were evaluated by five endoscopists. Relative visibility between less-air and standard-air conditions of the brownish area, brownish color change of the epithelium, and dilated intrapapillary capillary loop (IPCL) were graded as 5 (definitely better under less-air condition) to 1 (definitely worse under less-air condition), with 3 indicating average visibility (equivalent to standard-air observation). Results The mean (standard deviation) visibility score of the brownish area, brownish color change of the epithelium, and dilated IPCLs under less-air condition were 3.94 (0.58), 3.73 (0.57), and 4.13 (0.60), respectively, which were significantly better than that under standard-air condition (p < 0.0001). Esophageal SCC evaluated as ≥ 4 in the mean visibility score of the brownish area, brownish color change of the epithelium, and dilated IPCLs accounted for 50% (51/101 lesions), 34% (34/101 lesions), and 67% (68/101 lesions), respectively. Conclusions The present results suggested that NBI with less air might improve the visibility of flat type esophageal SCC compared with NBI with standard air. Less-air NBI observation may facilitate the detection of flat type esophageal SCC. Trial registration The present study is a non-intervention trial.

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