Cases Of Early Esophageal Cancer Research Articles

DESIGN AND ANALYSIS OF IODINE STAINING AND NBI IN THE DIAGNOSTIC MODEL AND DIAGNOSIS OF EARLY ESOPHAGEAL CANCER AND ITS PRECANCEROUS LESIONS

Objective: This study aimed to compare the differences between narrowband imaging (NBI) and Lugo’s iodine staining endoscopy (LCE) for detecting and elucidating the site, clarity, and diagnostic accuracy of early esophageal cancer and precancerous lesions. Methods: We included patients with a high risk of developing esophageal cancer who visited the Zhongjiang County People’s Hospital between October 2020 and October 2022. Endoscopic examination was performed on each study participant. White-light endoscopy was used to observe and locate the diseased mucosa, after which NBI mode and LCE staining were used to observe the boundary between the diseased and normal mucosa. Abnormal lesions were found, and biopsies were performed on the identifiable diseased parts for pathological examination. Inflammation, LGIN, HGIN, and early esophageal cancer were diagnosed, and the differences between them were compared in terms of the two enhanced-image endoscopy techniques. A semantic segmentation model based on deep learning was adopted to assist in the diagnosis of early esophageal cancer and accurately locate cancerous areas. In order to improve its accurate diagnostic rate, we also built a semantic segmentation network model to assist in the computer-aided diagnosis of early esophageal cancer. Results: A total of 69 cases of early esophageal cancer were included in this study. The patients were aged 40–75 years, with an average age of [Formula: see text] years. Most early esophageal cancer lesions were located in the middle of the esophagus in 45/69 (65.2%) cases. LCE obtained higher clarity of lesion boundaries than NBI (59.4% versus 45.0% and 27.7% versus 15.9%, respectively), and the proportion of unclear lesions was lower (8.6% versus 21.7% and 4.3% versus 17.4%, respectively; [Formula: see text]). For early esophageal cancer and precancerous lesions, the missed-diagnosis rate of white-light endoscopy was 20%, that of NBI was 3.15%, and that of LCE was 0%, with statistical significance ([Formula: see text]). The rate of missed diagnosis of LGIN (three cases) by NBI was 3.15%, which was not significantly different from that of LCE ([Formula: see text]). We found that the lesion area could be more accurately determined using deep learning models to segment NBI images. By constructing a deep learning model for the diagnosis and classification of esophageal cancer, its diagnostic rate rose to 99.5%. Conclusion: The age range of patients with early esophageal cancer in Zhongjiang County, Sichuan Province, was 40–75 years, and tumors mostly occurred in the middle of the esophagus. The boundary clarity of early esophageal carcinomas was higher on LCE than that on NBI. The diagnostic accuracies of NBI and LCE are much higher than those of conventional white-light endoscopy. Therefore, both LCE and NBI are helpful for detecting early esophageal cancer and precancerous lesions. Moreover, the diagnostic rate of clinical esophageal cancer can be effectively improved using a dedicated deep learning network model.

Water pressure method combined with magnifying endoscopy for esophageal endoscopic submucosal dissection.

Poor visual field and limited submucosal space could obstruct endoscopic submucosal dissection (ESD) and increase the risk of complications. In this manuscript, we presented ESD assisted by water pressure method and magnifying endoscopy for a difficult case of early esophageal cancer.

Application Value of the Diagnosis during Early Carcinoma of Upper Digestive Tract Based on Optical Enhanced Endoscopic Technique.

Objective The diagnostic value of optical enhanced endoscopy in early cancer of upper digestive tract was studied by comparing the disease accuracy, tumor type, invasion, and various surgical indicators between the two groups. Methods 188 patients with early upper gastrointestinal cancer treated in our hospital from January 2020 to February 2021 were selected as the research objects. The patients were randomly divided into the observation group and control group with 94 cases in each group. Results The accuracy of early detection of early carcinoma of upper digestive tract in the observation group was 94.68% and that in the control group was 76.60%. The accuracy of the observation group was significantly higher than that in the control group, with statistical significance (P < 0.05). In the observation group, 36 cases of early gastric cancer, 28 cases of early esophageal cancer, and 30 cases of early colorectal cancer were detected; 25 cases of early gastric cancer, 19 cases of early esophageal cancer, and 28 cases of early colorectal cancer were detected; 26 cases of early carcinoma of upper digestive tract infiltration were detected; and 68 cases were not detected, and the detection rate was 27.66%, which was higher than 9.57% in the control group, and the difference was statistically significant (P < 0.05). After different methods of treatment, no death occurred in all patients. Except for the operation time, the surgical indexes of the observation group were better than the control group, the difference was statistically significant (P < 0.05). Conclusion Optical enhanced endoscopic technique had obvious effect in the diagnosis of patients with early cancer of upper digestive tract, it was helpful to improve the clinical detection rate of early carcinoma of upper digestive tract and had certain diagnostic ability for the invasion depth of early cancer of high upper gastrointestinal tract, which was conducive to the detection of clinical invasion lesions and had high clinical promotion and application value.

A case of early esophageal cancer on esophageal varices treated by endoscopic submucosal dissection after endoscopic variceal ligation

A case of early esophageal cancer on esophageal varices treated by endoscopic submucosal dissection after endoscopic variceal ligation

Focus on patients with early esophageal cancer-a prognostic nomogram.

BackgroundEsophageal cancer is a common cancer of the digestive system, with high morbidity and poor prognosis. However, while the prognosis of early esophageal cancer is relatively good, there is no effective model to accurately predict the prognosis of early esophageal cancer. The Aims of this study are to explore risk factors for the prognosis of early esophageal cancer and to establish a prediction nomogram for patients.MethodsSurveillance, Epidemiology and End Results (SEER) Stat 8.3.5 was used to collect 2,351 cases of early esophageal cancer from 2004 to 2015 in the SEER database. Early esophageal cancer is defined as a lesion that is confined to the lamina propria and the muscularis mucosa. Prognostic factors were analyzed with the log-rank method and a Cox proportional hazard model by SPSS (v25.0). Independent prognostic factors were used to construct a nomogram with a Cox proportional hazard model. The C-index was used to evaluate the prediction effect of the nomogram. The internal validity of the nomogram was tested by discrimination and calibration using a bootstrap method with 1,000 resamplings.ResultsThe median survival time was 30 months, and the 1-, 3-, and 5-year survival rates were 65.2%, 46.8%, and 41.6%, respectively. The male to female ratio was 3:1, and 85.33% of all patients were white. Univariate analysis showed that risk factors affecting patient prognosis included age (χ2=430.631, P<0.001), sex (χ2=48.1, P<0.001), marital status (χ2=107.597, P<0.001), race (χ2=58.928, P<0.001), primary site (χ2=98.675, P<0.001), tumor grade (χ2=116.421, P<0.001), surgery (χ2=1,259.33, P<0.001) and histologic type (χ2=231.062, P<0.001). Using multivariate analysis, we found that age (HR=1.787, 95% CI: 1.58–2.03), marital status (HR=0.774, 95% CI: 0.69–0.87), tumor grade (HR=1.241, 95% CI: 1.14–135), and surgery (HR=0.356, 95% CI: 0.33–0.39) were independent prognostic factors for patients with early esophageal cancer. We constructed the nomogram with the above independent factors, and the C-index value was 0.788.ConclusionsThis study obtained the latest epidemiological information on early esophageal cancer and determined that age, marital status, tumor grade and surgery were independent prognostic factors for early esophageal cancer. The nomogram developed with these factors could provide good prognosis prediction.

Analysis of risk factors for non-curative resection after endoscopic submucosal dissection in early esophageal cancer and high-grade intraepithelial neoplasia

Objective To investigate the risk factors for non-curative resection after endoscopic submucosal dissection (ESD) for early esophageal cancer and high-grade intraepithelial neoplasia. Methods The clinicopathological data of 427 cases of early esophageal cancer and high-grade intraepithelial neoplasia who underwent ESD was performed from January 2013 to December 2016 in the Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. According to the results of postoperative pathology and immunohistochemistry, 339 patients were defined as curative resection group and 88 patients were defined as non-curative resection group. Chi-square test, univariate analysis and multivariate logistic regression analysis were used for statistical analysis. Results A total of 427 patients were enrolled in this study, with an average age of (63.2±7.7) years, including 96 cases of early esophageal cancer and 331 cases of high-grade intraepithelial neoplasia. The enbloc resection rate of ESD was 94.8%(405/427), 88 of them were non-curative resected, and the non-curative resection rate was 20.6%. Univariate analysis showed that early esophageal cancer (odds ratio (OR)=3.682, 95% confidence interval (CI) 2.216 to 6.118, P<0.01), submucosal infiltration (OR=10.220, 95%CI4.861 to 21.481, P<0.01), ESD indications (OR=6.005, 95%CI3.545 to 10.172, P<0.01) and lifting sign after injecting at the base of lesions (OR=2.508, 95%CI1.005 to 6.255, P=0.042) were statistically significant between non-curative resection group and curative resection group. Multivariate unconditional logistic regression analysis revealed that submucosal infiltration (OR=4.329, 95%CI1.758 to 10.661, P=0.001), not absolute indications of ESD (OR=6.484, 95%CI2.205 to 19.068, P=0.001) and negative lifting sign (OR=3.182, 95%CI1.171 to 8.651, P=0.023) were independent risk factors for non-curative resection. Conclusions Patients with early esophageal cancer, submucosal infiltration, not absolute indications for ESD and negative lifting signs are prone to non-curative resection. Moreover, submucosal infiltration, not absolute indications for ESD, and negative lifting signs are the independent risk factors for non-curative resection. Key words: Endoscopic submucosal dissection; Early esophageal cancer; Precancerous lesions; Non-curative resection

The accumulating appreciation of endoscopic submucosal dissection in the treatment of gastrointestinal neoplasms: preliminary experience in local eastern China.

Endoscopic submucosal dissection (ESD), an emerging technique originated from Japan, has been introduced into China in recent years. The aim of this study was to evaluate the efficacy and safety of ESD in the treatment of gastrointestinal (GI) neoplasms. Early GI neoplasms (n=41) in 40 patients from local Eastern China were treated with ESD at Zhejiang Provincial People's Hospital and followed-up from January 2009 to December 2011. Postoperative pathology, complications and therapeutic outcomes were retrospectively analyzed. Mean size of the resected lesions was 2.2±0.81cm (1.2-6.0cm) and mean operation time was 77±28 minutes (20-150 minutes). The rates for successful resection, en bloc resection and complications were 90.2% (37/41), 83.8% (31/37) and 9.8% (4/41), respectively. The postoperative pathology showed 4 cases of early esophageal cancer, 6 of early gastric cancer or high-grade intraepithelial neoplastic changes, 5 of rectal laterally spreading tumor, 5 of esophageal or gastric leiomyoma, 2 of gastric heterotopic pancreas, and 18 of esophageal and gastric flat lesions with low-grade intraepithelial neoplastic changes. Tumor residue or recurrence was not been detected in all 40 patients during follow-up. According to our experience in local Eastern China, ESD is a feasible technique for the treatment of GI neoplasms. Even though it has promising resection rate and acceptable complication rate, the indication of ESD should be selected strictly and the operators need to be well-trained.

Clinical analysis and endoscopic findings of early esophageal cancer

Objective To research the characteristics of early esophageal cancer's endoscopy and its clini-cal diagnosis. Methods Retrospective analyze the clinical symptoms and endoscopy performance of the 24 cases of early esophageal cancer which were confirmed by opemtion. Results Unaided eye observing of 24 cases of early e-acphageal cancer:diameter of pathological changes within 1.0 cm,there are four cases of the surface rough,turbidity,vascular fuzzy texture, congestive mucosa, small pieces of rotten to the core, around the realm of clear, easy bleeding by touch of three cases. Mucosa focal irregular plaquelike erosion or superficial helcosis of five cases Mucosa mild uplift,smooth surface or erosion, with slightly different colors of 10 cases ( including one case of pelypoid change) Mucosa fo-cal wormhole-like change, a slight hollow, moss-covered, rubeosis or bleeding lesions after water rinse, irregular and clear borders of two cases, pathology report: one case of small cell carcinoma,one case of adenocarcinoma (cardia),High-level intraepithelial neoplasia transformation nine cases, one case of poorly differentiated adenocarcinoma, 12 ca-ses of squamous cell carcinoma. Conculsion Endoscopic early esophageal cancer for the mainfeatures of the mucous membrane color changes, mucosal thickening, transparency and mucosal vascular network st ructure changes, and mu-cosal rough, nodules, plaques, erosion and uplift superficial, shallow depression and other patterns chang, GeneraUe-sions were confined or isolated like chang, irregular, and the mucous membrane around the borderclear. Clinicalofte misdiagnosed, missed diagnosis, early diagnosis to have significant value. Key words: Esophageal neoplasms; Gastroscopy

Evaluation of Complication Rate and Safety of Endoscopic Submucosal Dissection (ESD)

Backgrounds and Aims: ESD is a standard endoscopic therapy of early gastric cancer (EGC) and Early esophageal cancer (EEC) which ha invaded to the mucosal or submucosal layer. ESD can be nowadays performed with more expanded indications compared to conventional endoscopic mucosal resection. We evaluate the complication rate and safety of ESD. Materials and Methods: We retrospectively reviewed 511 cases of EGC, EEC, gastric adenoma, and gastric submucosal tumors treated with ESD at Digestive Disease Center, Soon Chun Hyang University Hospital from February, 2003 to November, 2006.

Endoscopic Mucosal Resection of Early Esophageal Cancers: Our Method

Though endoscopic mucosal resection (EMR) may provide definitive treatment for selected cases of early esophageal carcinoma, the standard method has not been determined yet. There have been several EMR techniques so far developed, including strip biopsy, EMR using a cap, Makuuchi tube method, etc. The selection of EMR method largely depends on personal experience and preference of an endoscopist. Here we present our EMR method along with its advantages and disadvantages. With the extension of indications, more cases of early esophageal cancer will be treated by EMR. Since only long‐term results tell what the ideal EMR method is, well‐designed comparative studies are necessary in the future to establish a standard method.

右側大動脈弓に合併した0-Ⅱ型食道粘膜癌の1例

右側大動脈弓に合併した0-Ⅱ型食道粘膜癌の1例

Ｆｌｅｘｉｂｌｅ Ｅｎｄｏｓｃｏｐｉｃ Ｓｕｒｇｅｒｙ―適応と手技 Ｄ． 食道疾患

Endoscopic treatment for esophageal diseases has been developed with the progress of the diagnostic techniques in recent years. It can be assumed that no doctor uses a rigid type of endoscope any more concerning to gastrointestinal diseases. Removal of a foreign body or a benign tumor and treatment of stenosis or esophageal varices, have become routine works for endoscopists. Although, the numbers of cases of early esophageal cancer have been increasing recently, improvement of diagnosis of the lymphnode metastasis and accurate detection of depth of cancer invasion make it possible to clarify which cancer can be treated endoscopically. In an endoscopic treatment for cancer, there are several techniques, such as laser or heat-probe. Among these techniques, an endoscopic mucosal resection is the most prevailing.

早期食道癌２０例の検討 とくにｓｍ早期癌の治療方針について

早期食道癌２０例の検討 とくにｓｍ早期癌の治療方針について

Endoscopic laser therapy in the curative and palliative treatment of upper gastrointestinal cancer

Endoscopic laser treatment was initially applied for gastrointestinal bleeding, but has been actively extended, especially in Japan, to the curative treatment of early upper gastrointestinal cancers. We have treated 10 cases of early gastric cancer and 1 case of early esophageal cancer by Nd-YAG laser radiation, and 2 cases of early gastric cancer by photochemical therapy (PCT) with argon laser + hematoporphyrin derivative. Also, 62 cases of advanced cancer were treated, 10 of the esophagus and 52 of the stomach, for bleeding (18 cases) or stenosis (34 cases). The cases were nonresectable or they were patients who refused surgery. Satisfactory results were obtained by treatment with YAG laser, but have not yet been obtained with PCT. In order to find indications for the possible extension of endoscopic laser therapy to operable cases of early gastric cancer, we studied lymph node metastases in 200 cases of early gastric cancer surgically treated by us. It was found that early gastric cancers (both mucosal and submucosal) measuring less than 2 cm in diameter, of type I, IIa, and IIc (without ulcer scar), had no lymph node metastases and such cases can be treated by local therapy--such as endoscopic laser therapy. In palliative endoscopic laser therapy for complications of advanced gastrointestinal cancers, there are no major problems with active performance. We obtained a high (90%) hemostatic rate in bleeding cases of upper gastrointestinal cancer and a satisfactory (65%) rate of dilating effect in cases of cancerous stenosis at the esophagus and cardia.(ABSTRACT TRUNCATED AT 250 WORDS)

粘表皮癌と診断された早期食道癌の１切除例

粘表皮癌と診断された早期食道癌の１切除例

食道アカラシアに合併した早期食道癌の１治験例

食道アカラシアに合併した早期食道癌の１治験例

Endoscopic Diagnosis of 115 Cases of Early Esophageal Carcinoma

Mass surveys of a population of 28,139 people in high-risk areas for esophageal carcinoma in Henan Province were carried out using the methods of esophageal exfoliative cytology, reontgenology and fiberendoscopy, between January 1978 and May 1981. 115 cases of early esophageal cancer comprising 64 males and 51 females were found. This paper reports on the results of the fiberendoscopic examination of these 115 cases of early esophageal carcinoma followed-up at regular intervals. On the basis of clinical, laboratory, and endoscopic findings, esophageal carcinoma of early stage can be divided into four types including the congestive type, erosive type, plaque-like type and polypoid type. All results were obtained on the basis of a follow-up observation period of 19-42 months. It was shown that the evolution of esophageal cancer in situ to an advanced cancer probably takes 3-4 years. Therefore, esophageal carcinoma could be reasonably considered to be a chronic disease of relatively slow growth. In order to make complete cure of such a "poor-prognosis" disease possible, early diagnosis established in good time using all the methods mentioned, is essential.

上部消化管悪性腫瘍に対するYAGレーザー治療

Laser endscopy was applied to treat six cases of gastric cancer, a case of advanced gastric cancer and a case of early esophageal cancer. All cases ware males and two cases revealed type I, three cases type IIa, two cases type IIc and one case Borrmann III morphologically. Operation was not indicated in five cases because of associated diseases such as angina pactoris, liver cirrhosis, cardiac failure and postoperative status of malignancies. The mean age of five cases was 74 years old.Laser irradiation was perfomed with the condition of 50 W/0.5 to 1 second from the distance of 1 cm in principle. This treatment was done for one to three days and the lesion was irradiated 14 to 120 times in each treatment. Three cases were successfully operated after laser therapy. Only the complication experienced was a perforation of the stomach due to direct irradiation to the ulcer although the patient was operated successfully. Five cases have been serially followed up for two to twelve months by the endoscopic biopsy and all have been still pathologically negative.These data suggest that endoscopic YAG laser therapy could he applicable to those patients with early gastric and esophageal cancer who cannot tolerate surgical intervention.

The Present State of Surgical Treatment of the Thoracic Esophageal Cancer

One thousand, six hundred and twenty-seven cases of the esophageal cancer have been admitted to our hospital for these fourteen years. The resection of the esophagus was performed in 846 cases (52%). Another surgical procedures were performed in 490 cases and no surgical treatment was carried out in the remaining cases. Considering the long-term-survival rate, 5-year-survival rate of the resected cases was 22%, otherwise, that of the non-resected cases was 1% even if the radical irradiation was performed. Till the end of last year, the thoracic esophageal cancers have been resected in 868 cases in our hospital. The operative mortality rate was 4.5%.The operation of the thoracic esophageal cancer is usually constituted of the subtotal resection of the thoracic esophagus with the systemic cleaning of the lymphnodes and the reconstruction of the esophagus using stomach, colon and small intestine. As the reconstruction of the esophagus, ante-thoracic esophagogastrostomy (Nakayama's method) was performed most frequently in our hospital. This had many advantages, otherwise to improve the sole disadvantage, high incidence of suture insufficiency, some modified operative techniques have been applied.The 10-year-survival rate after operation was 13%. From the analysis of the 10-year-survival rate, the patients with cancers less than 6cm in size on X-ray film, of which invasion revealed within the muscular layer, with no lymphnode involvement, being resected curatively and of histologically well differentiated type, had superiority in long-term survival.To obtain better results in the long-term survival, it is important to find out early cancer of the esophagus. The early esophageal cancer was defined as the cancer of which infiltration was limited in the submucosa without any metastasis. Twenty-eight cases of early esophageal cancer was operated in our hospital for these fourteen years. These were 3.5% of the cancer cases of total esophageal resections. The 5-year-survival rate of the early esophageal cancer was 64%. As for the diagnostic procedures, esophagoscopy was more advisable for discovery of the erosive type of cancer. Mucosal cancer was seen in 3 of 28 cases. All mucosal cancers revealed endoscopically erosive types. So X-ray examination and esophagoscopy are necessary to find out tiny and erosive lesions of the esophagus in screening examination. The endoscopic dye method using 2% toluidine blue solution and 3% Lugol solution, was advisable to detect the mucosal and intraepithelial cancer. The extent of the intraepithelial invasion of cancer and the tiny accessory lesions could be clearly demarcated by this method.In this report the present state of surgical treatment of the thoracic esophageal cancer and the diagnosis of early cancer are presented. The purpose of the surgery of thoracic esophageal cancer is placed not only for decrease of the mortality rate, but also for improvement of the long-term-survival rate after operation.

Evaluation of cancerous infiltration into the esophageal wall in esophageal cancer—in relation to 2 cases of early esophageal cancer

Evaluation of cancerous infiltration into the esophageal wall in esophageal cancer—in relation to 2 cases of early esophageal cancer