Magnifying Endoscopy With Narrow Band Imagining And Endoscopic Ultrasonography In The Invasion Depth Of The Early Esophageal Carcinoma

Objective:The main purpose of this paper is to investigate the value of magnifying endoscopy with narrow band imagining and endoscopic ultrasonography in the diagnosis of early esophageal carcinoma and precancerous lesions,so as to help patients choose the most appropriate scheme in the preoperative evaluation of endoscopic diagnosis and treatment.Methods:The endoscopic data of patients with suspected early esophageal carcinoma were collected and analyzed retrospectively from May 2018 to October 2019 in the digestive endoscopy center of the first affiliated Hospital of Zhengzhou University.Before surgery,all patients underwent Inoue classification of the intraepithelial papillary capillaries of the lesion,and at the same time underwent endoscopic ultrasonography to assess the depth of infiltration of the lesion.Patients choose endoscopic or surgical removal of the lesion.We analyzed the consistency between the Inoue classification and endoscopic ultrasonography evaluation results with the postoperative pathological results,and compared the accuracy of the Inoue classification and endoscopic ultrasonography in judging the depth of early esophageal cancer invasion.Results:1.This study included 80 patients with 80 lesions,There were 13 cases of type IV under endoscopy before surgery,inciuding 3 cases of LGIN,and 10 cases of Ml stage after postoperative pathology;There were 23 cases of type V1,including 2 cases of LGIN,19 cases of Ml stage,1 case of M2 stage,and 1 case of SM1 stage after postoperative pathology;There were 22 cases of V2 type,including 1 case of LGIN,1 case of Ml stage,18 cases of M2 stage,2 cases of M3 stage after postoperative pathology;There were 17 cases of type V3,including 1 case of Ml stage,1 case of M2 stage,8 cases of M3 stage,5 cases of SM1 stage and 2 cases of SM2 stage after postoperative pathology;There are 5 cases of Vn type,including 1 case of M2 stage,1 case of M3 stage and 3 cases of SM2 stage after postoperative pathology;Compared with the pathological results,63 of the 80 cases were correctly diagnosed with IPCL classification of ME-NBI,and the overall accuracy rate was 78.75%.The consistency of the IPCL classification observed by narrow-band imaging magnifying endoscopy and postoperative pathological grading of patients was checked,which showed good consistency(Kappa=0.637).2.There were 66 cases of lesion infiltration depth diagnosed as mucosal layer by endoscopic ultrasonography before surgery,including 5 cases of LGIN,59 cases of M stage and 2 cases of SM stage after postoperative pathology;There were 14 cases of lesion infiltration depth diagnosed as submucosa by endoscopic ultrasonography before surgery,including 1 case of LGIN,4 cases of M stage and 9 cases of SM stage after postoperative pathology.Compared with the pathological results,68 of the 80 cases were correctly diagnosed by the endoscopic ultrasonography,and the overall accuracy rate was 85.00%.The consistency of the infiltration depth observed by endoscopic ultrasonography and pathological infiltration results of patients was checked,which showed good consistency(Kappa=0.540).3.There was no statistically significant difference between ME-NBI Inoue classification and endoscopic ultrasonography in judging the depth of esophageal early cancer invasion.There was no statistically significant difference between the accuracy of ME-NBI Inoue typing and the results of endoscopic ultrasonography(χ2=1.477,P=0.224).Conclusion:1.Inoue classification has a certain accuracy rate,which is in good agreement with the pathological results.It can be applied to the general investigation of esophageal precancerous lesions,but the accuracy rate of some subtypes is low(type Ⅳ、Vn).2.The results of endoscopic ultrasonography and pathology are moderately consistent,this indicates that endoscopic ultrasonography has certain application value for the staging of early esophageal carcinoma.3.There is no significant statistical difference in the accuracy of Inoue classification and endoscopic ultrasonography in judging the depth of early esophageal carcinoma invasion.It is recommended that a variety of methods be used clinically to determine the depth of early esophageal carcinoma invasion,to help patients with early esophageal carcinoma choose the most appropriate scheme in the preoperative evaluation of endoscopic diagnosis and treatment.