| Objective:To investigate the preferable methods of preoperative examination for superficial esophageal squamous cell carcinoma?SESCC?by comparing magnifying endoscopy-narrow band imaging?ME-NBI?and endoscopic ultrasonography?EUS?to provide patients with the optimal diagnosis and treatment and improve their survival period as well as quality of life.Methods:We enrolled the clinical and pathological data of patients with esophageal squamous cell carcinoma confirmed by biopsy from January 1,2015 to December 30,2018 in our hospital.The pathological results of postoperative specimens were taken as the"gold standard".We compared the consistence between postoperative pathological findings and the three aforementioned preoperative endoscopic findings?AB classification,AVA classification and EUS?,respectively.We also studied the sensitivity,accuracy and specificity of each subtype in assessing the depth of tumor invasion,each module.The feasibility of the combination of these modules were analyzed as well.Results:A total of 97 patients with 109 lesions were enrolled in this study,including 89 patients with 101 lesions assessed by AB classification,40patients with 40 lesionsby AVA classification,72 patients with 77lesions by EUS.All of their results were consistent with the postoperative pathological results in medium?AB classification:Kappa=0.692,P<0.001;AVA classification:Kappa=0.604,P<0.001;EUS:Kappa=0.747,P<0.001?.In AB classification,the sensitivity,specificity and accuracy of B1 subtype were 85.42%,90.57%and 88.12%;the sensitivity,specificity and accuracy of B2 subtype were 76.92%,83.87%and 81.19%;and the sensitivity,specificity and accuracy of B3 subtype were 78.57%,95.40%and 93.07%.In AVA classification,the sensitivity,specificity and accuracy of AVA-small subtype were 93.33%,84.00%and 87.50%;the sensitivity,specificity and accuracy of AVA-middle subtype were 70.59%,82.61%and 77.50%;and the sensitivity,specificity and accuracy of AVA-large subtype were 50.00%,93.75%and 85.00%.In EUS,the sensitivity,specificity and accuracy of M-layer judgment were 89.36%,86.67%and 88.31%;the sensitivity,specificity and accuracy of SM-layer assessment were 84.62%,88.24%and 87.01%;and the sensitivity,specificity and accuracy of Advance assessment were 75.00%,100%and98.70%.In addition,there were 40 patients with 40 lesions were assessed by AB classification combined with AVA classification preoperatively.It showed that the result of combined moduleswas more correlated with pathological results than AVA classification alone(P=5.2794×10-4),while there was no significant difference between combined modules and AB classification alone?P=0.4546?.There were 64 patients with 69 lesions were assessed by AB classification combined with EUS preoperatively.It showed that the result was more correlated with pathological results by combined methods than EUS alone(P=6.246×10-11),while there was no significant difference between combined methods and AB classification alone?P=0.0609?.Conclusion:Both ME-NBI and EUS provide a comparable performance judging assessing the depth of invasion of SESCC preoperatively.The combination of ME-NBI and EUS demonstrated superior results than a single module.Moreover,they are complementary to each other.Accordingly,it is recommended to use the combined methods to assess the depth of of SESCC invasion preoperatively. |
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