ENDOSCOPIC DIAGNOSIS OF INTRAEPITHELIAL SQUAMOUS NEOPLASIA IN HEAD AND NECK AND ESOPHAGEAL MUCOSAL SITES

doi:10.1111/j.1443-1661.2006.00616.x

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Wiley InterScience

Digestive Endoscopy

Volume 18 Issue s1, Pages S2 - S5

Published Online: 6 Jul 2006

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ENDOSCOPIC DIAGNOSIS OF HYPOPHARYNGEAL, ESOPHAGEAL AND GASTRIC NEOPLASM

ENDOSCOPIC DIAGNOSIS OF INTRAEPITHELIAL SQUAMOUS NEOPLASIA IN HEAD AND NECK AND ESOPHAGEAL MUCOSAL SITES

Manabu Muto,* Yasushi Sano,* Satoshi Fujii, ^† Atsushi Ochiai ^† and Shigeaki Yoshida*

*Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East and ^† Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan

Correspondence to Manabu Muto, Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Japan. Email: mmuto@east.ncc.go.jp

KEYWORDS

esophageal cancer • head and neck cancer • magnified endoscopy • narrow-band imaging • squamous dysplasia

ABSTRACT

In the multistep process of squamous epithelial carcinogenesis, squamous epithelial dysplasia has been considered to be a preinvasive stage of squamous cell carcinoma. If we could distinguish a dysplasia at high risk, such lesions could be targets for local treatment such as endoscopic mucosal resection to avoid the transformation to invasive carcinoma. Narrow-band imaging, a new optical technology, is useful to identify the cancerous lesion compared to conventional white light image. In addition, narrow-band imaging combined with magnifying endoscopy makes it possible to visualize the changes of microvascular architecture occurring in the epithelium. To evaluate whether these endoscopic findings are reliable to diagnose a dysplasia at high risk, a prospective study on the basis of the standards for reporting diagnostic accuracy initiative is needed. If endoscopic assessment of intraepithelial squamous neoplasia is reliable, it would be of benefit to the patients' outcome and improve cost effectiveness of care because of the avoidance of developing invasive carcinoma and the reduction of unnecessary biopsies.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1443-1661.2006.00616.x About DOI