Application Value Of Optical Enhanced Staining In Screening For Early Esophageal Cancer And Precancerous Lesions

Background and Purpose:China is a high occurrence region of Esophageal Cancer(EC),and more than half of EC occurs in the world in our country,mainly for Esophageal Squamous Cell Cancer(ESCC).Most patients with EC have a typical or even asymptomatic symptoms at the early stage of the disease,and can not seek medical treatment voluntarily in time,leading to the delay of the disease,and the disease has reached the advanced stage when the diagnosis is made.EC results in poor prognosis,high mortality and very low 5-year survival rate.Endoscopic intervention in the early stage of EC is effective.The cure rate and 5-year survival rate of early esophageal cancer after endoscopic treatment are more than 90%.Therefore,the screening of early esophageal cancer is very important.At present,endoscopic screening for early esophageal cancer mainly relies on endoscopy.Endoscopic iodine staining is widely used and mature,and its positive effects have been confirmed.Optical Enhancement(OE)staining is a novel electron staining method that combines optical and digital images.The application value of OE in screening for early esophageal cancer has not been studied at home and abroad.In this study,the value of OE combined with Magnifying Endoscope(ME)for screening early esophageal cancer was investigated by comparing the observations of OE,OEME and iodine staining for early esophageal cancer and precancerous lesions.Methods:In this study,patients who underwent gastroscopy from January 2021 to December 2022 at the Endoscopy Center of the First Affiliated Hospital of Henan University were collected,and the above patients received iodine staining and OE electron staining during the examination.According to the inclusion and exclusion criteria,64 cases were finally included.Gender,age,smoking history,drinking history,family history of tumor,history of diabetes,history of hyperlipidemia,location,number,size,pathological diagnosis of esophageal mucosal lesions detected by OE or iodine staining,OE esophageal observation time,and iodine staining esophageal observation time of 64 patients were collected.Endoscopic Mucosal Resection,JES classification in OE-ME mode and endoscopic mucosal resection,Pathological results(pathological diagnosis,depth of invasion)after surgery in the Endoscopic or Endoscopic Submucosal Dissection(ESD)or EMR.All data were analyzed and mapped by SPSS 25.0 and Graph Pad Prism software,and P < 0.05 was considered statistically significant.Results:1.The sensitivity,specificity,positive predictive value and negative predictive value of OE for the detection of positive esophageal lesions were 95.90%,85.70%,95.90% and 85.70% respectively.The sensitivity,specificity,positive predictive value and negative predictive value of iodine staining were 91.90%,76.20%,93.00% and 72.70% respectively.The diagnostic results under OE electronic endoscopy were almost completely consistent with those under iodine staining endoscopy,with statistical significance(Kappa=0.850,P < 0.001).2.The observation time of the esophagus by OE electron staining(52.86±60.60s)was less than that by iodine staining(180.05 ± 29.93s),and the difference was statistically significant(t=-8.618,P <0.001).3.Esophageal mucosal IPCLs were observed in OE-ME,and the depth of infiltration of positive esophageal lesions was diagnosed according to IPCL morphology.The sensitivity,specificity,positive predictive value and negative predictive value of B1 in the diagnosis of EP and LPM were 91.67%,81.82%,84.62% and 90.00%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of B2 in diagnosing MM and SM1 were 66.67%,85.71%,75.00% and 80.00%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of B3 in the diagnosis of SM2 and SM3 were 50.00%,95.24%,50.00% and 95.24%,respectively.Conclusions:1.OE electron staining and iodine staining have high diagnostic value in the screening of early esophageal cancer and precancerous lesions.OE staining takes less time and is applicable to a wide population,and can be combined with ME for fine observation of diseased microvessels.2.The B1 microvascular model observed by OE-ME has a high value in predicting the depth of invasion of esophageal lesions,while the B2 and B3 microvessels observed by OE-ME require other auxiliary means to determine the depth of invasion of esophageal lesions.