Narrow Band Imaging (NBI) System Is Promising Device to Detect Superficial Pharyngeal Cancer At An Early Stage in Patients with Esophageal Squamous Cell Carcinoma (SCC) Satoru Nonaka, Yutaka Saito, Takuji Gotoda, Takahiro Kozu, Takahisa Matsuda, Ichiro Oda, Haruhisa Suzuki, Daizo Saito Introduction: According to the well known concept of ‘‘field cancerization’’ head & neck and esophageal cancers frequently co-exist either synchronously or metachronously. However oropharyngeal and hypopharyngeal cancer remains difficult to detect before progression. NBI with magnifying view seems to be able to identify superficial pharyngeal cancer which is otherwise extremely difficult to be detected. Early detection of pharyngeal cancer might benefit patients with esophageal SCC. Aims and methods: To evaluate the feasibility of NBI system for early detection of pharyngeal cancer, 76 patients who had undergone treatment for esophageal SCC (48 after chemoradiotherapy (CRT), 28 after surgery) were prospectively studied between April and November 2005. Gastroscopy was performed using NBI with magnifying view. Brownish area and irregular intraepithelial papillary capillary loop (IPCL) with high density were appreciated as endoscopic features of superficial pharyngeal cancer by NBI. Those lesions having NBI features of pharyngeal cancer were biopsied in the standard manner. A magnifying endoscope with 80X magnification (GIF-Q240Z), EVIS LUCERA and NBI system (Olympus, Tokyo, Japan) were used. Results: Superficial pharyngeal cancer was detected in 7 of 76 patients (9.2%). There were 9 lesions in total. 5 of the 7 patients were post CRT and the remaining 2 were post surgery. All lesions were revealed as SCC histologically. 8 lesions were located in hypopharynx and one in the oropharynx. 6 were located on the right side, 1 in the center, and 2 on the left side. Using the esophageal cancer macroscopic classification 3 of the tumors could be classified as 0-IIb, 1 as 0-IIb C IIa, 4 as 0-IIa, and 1 as 0-IIc. The median size of lesions was 10 mm (range; 5-20 mm). 4 lesions with a median size of 7.5 mm (range; 5-20 mm) impossible to detect by conventional endoscopy were 0-IIb and 0-IIb C IIa. 5 lesions with a median size of 15 mm (range; 10-20 mm) possible to be detected by conventional endoscopy were 0-IIa and 0-IIc. Conclusions: NBI system is promising device to detect superficial pharyngeal cancer at an early stage in patients with esophageal SCC.
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Apr 1, 2007
Satoru Nonaka + 5
