Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China
Abstract Objectives Endoscopic diagnosis of invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by white-light imaging (WLI) modality remains difficult. This study aims to clarify WLI-based features which are predictive for invasion depth of SESCC. Methods A two-phase study was...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-023-01153-z |
| _version_ | 1797806792126758912 |
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| author | Bin Wang Yadong Feng Jie Song Jifeng Ma Yan Liang Mengjie Li Xiaofen Wang Cui-e Cheng Ruihua Shi |
| author_facet | Bin Wang Yadong Feng Jie Song Jifeng Ma Yan Liang Mengjie Li Xiaofen Wang Cui-e Cheng Ruihua Shi |
| author_sort | Bin Wang |
| collection | DOAJ |
| description | Abstract Objectives Endoscopic diagnosis of invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by white-light imaging (WLI) modality remains difficult. This study aims to clarify WLI-based features which are predictive for invasion depth of SESCC. Methods A two-phase study was performed by enrolling 1288 patients with 1396 SESCC lesions. Endoscopic appearances, clinical characteristics and post-operative pathological outcomes were collected and reviewed. The association between lesion features and invasion depth were analyzed. A predictive nomogram was constructed for prediction of invasion depth. Results Among 1396 lesions in derivation and validation cohort, 1139 (81.6%), 194 (13.9%) and 63 (4.5%) lesions were diagnosed as lesions confined into the intraepithelium or the lamina propria mucosa (T1a-EP/LPM), lesions invading the muscularis mucosa (T1a-MM) or superficial submucosa (T1b-SM1) and tumor with moderate invasion into the submucosa or deeper submucosal invasion (≥ T1b-SM2), respectively. Lesion length > 2 cm (p < 0.001), wider circumferential extension (p < 0.001, 0.002 and 0.048 for > 3/4, 1/2–3/4 and 1/4–1/2 circumferential extension, respectively), surface unevenness (p < 0.001 for both type 0-IIa/0-IIc lesions and mixed type lesions), spontaneous bleeding (p < 0.001), granularity (p < 0.001) and nodules (p < 0.001) were identified as significant factors predictive for lesion depth. A nomogram based on these factors was constructed and the values of area under the Receiver Operating Characteristics curve were 0.89 and 0.90 in the internal and external patient cohort. Conclusions Our study provides six WLI-based morphological features predicting for lesion depth of SESCC. Our findings will make endoscopic evaluation of invasion depth for SESCC more convenient by assessing these profiles. |
| first_indexed | 2024-03-13T06:12:44Z |
| format | Article |
| id | doaj.art-9c3a8df86d754d12bc25a58beeae49a0 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-13T06:12:44Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-9c3a8df86d754d12bc25a58beeae49a02023-06-11T11:09:05ZengBMCEuropean Journal of Medical Research2047-783X2023-06-0128111110.1186/s40001-023-01153-zAnalysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from ChinaBin Wang0Yadong Feng1Jie Song2Jifeng Ma3Yan Liang4Mengjie Li5Xiaofen Wang6Cui-e Cheng7Ruihua Shi8Department of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Gastroenterology, Maanshan 17th Metallurgy HospitalDepartment of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Gastroenterology, the Affiliated Changshu Hospital of Nantong University, Changshu No.2 People’s HospitalDepartment of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast UniversityAbstract Objectives Endoscopic diagnosis of invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by white-light imaging (WLI) modality remains difficult. This study aims to clarify WLI-based features which are predictive for invasion depth of SESCC. Methods A two-phase study was performed by enrolling 1288 patients with 1396 SESCC lesions. Endoscopic appearances, clinical characteristics and post-operative pathological outcomes were collected and reviewed. The association between lesion features and invasion depth were analyzed. A predictive nomogram was constructed for prediction of invasion depth. Results Among 1396 lesions in derivation and validation cohort, 1139 (81.6%), 194 (13.9%) and 63 (4.5%) lesions were diagnosed as lesions confined into the intraepithelium or the lamina propria mucosa (T1a-EP/LPM), lesions invading the muscularis mucosa (T1a-MM) or superficial submucosa (T1b-SM1) and tumor with moderate invasion into the submucosa or deeper submucosal invasion (≥ T1b-SM2), respectively. Lesion length > 2 cm (p < 0.001), wider circumferential extension (p < 0.001, 0.002 and 0.048 for > 3/4, 1/2–3/4 and 1/4–1/2 circumferential extension, respectively), surface unevenness (p < 0.001 for both type 0-IIa/0-IIc lesions and mixed type lesions), spontaneous bleeding (p < 0.001), granularity (p < 0.001) and nodules (p < 0.001) were identified as significant factors predictive for lesion depth. A nomogram based on these factors was constructed and the values of area under the Receiver Operating Characteristics curve were 0.89 and 0.90 in the internal and external patient cohort. Conclusions Our study provides six WLI-based morphological features predicting for lesion depth of SESCC. Our findings will make endoscopic evaluation of invasion depth for SESCC more convenient by assessing these profiles.https://doi.org/10.1186/s40001-023-01153-zSuperficial esophageal squamous cell lesionEndoscopic featuresWhite light imagingInvasion depthEndoscopic diagnosis |
| spellingShingle | Bin Wang Yadong Feng Jie Song Jifeng Ma Yan Liang Mengjie Li Xiaofen Wang Cui-e Cheng Ruihua Shi Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China European Journal of Medical Research Superficial esophageal squamous cell lesion Endoscopic features White light imaging Invasion depth Endoscopic diagnosis |
| title | Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China |
| title_full | Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China |
| title_fullStr | Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China |
| title_full_unstemmed | Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China |
| title_short | Analysis of white-light imaging-based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma: a retrospective multicenter study from China |
| title_sort | analysis of white light imaging based features predictive for determination of lesion depths of superficial flat esophageal squamous cell carcinoma a retrospective multicenter study from china |
| topic | Superficial esophageal squamous cell lesion Endoscopic features White light imaging Invasion depth Endoscopic diagnosis |
| url | https://doi.org/10.1186/s40001-023-01153-z |
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