Study of the Invasion Depth Diagnosis of Superficial Barrett’s Esophageal Adenocarcinoma- Identification of Large Vessels by Magnifying Endoscopy is Useful for the Diagnosis of Sub Mucosal Cancer

Objective: Superficial Barrett’s esophageal adenocarcinoma (S-BEA) has been treated by endoscopic procedures. Especially, intramucosal carcinomas have been treated by endoscopic mucosal resection (EMR) or endoscopic sub mucosal dissection (ESD). It is important to diagnose sub mucosal invasive lesions by endoscopy. However, it is difficult to diagnose with sub mucosal or mucosal BEA. Aim of this study that Observation of large vessels (LVs) by Magnified Endoscopy with narrow band imaging (ME-NBI) is useful for diagnosis of sub mucosal invasive S-BEA. Methods: We examined 50 cases of S-BEA. We diagnosed the depth of these lesions by white light imaging (WLI) and ME-NBI. Large vessels (LVs) with ME-NBI were defined as a diameter 2-3 times larger than surface capillary. Large vessels (LVs) observed with ME-NBI were defined those having a diameter 2-3 times larger than surface capillaries. If we could observe large vessels, we diagnosed sub mucosal (SM) invasive cancer. Results: Using WLI, the accurate diagnostic rate (AR) was 72%, sensitivity was 59%, specificity was79%, positive predictive value (PPV) was 59%, and negative predictive value was (NPV) 79%. With ME-NBI, the AR was 84%, sensitivity was 88%, specificity was 82%, PPV was 71%, and NPV 93%. Conclusion: Findings large vessels on the tumor using ME-NBI is useful for diagnosis of sub mucosal invasive S-EBA.LV is more objective findings of sub mucosal cancer.