ART OF DIAGNOSIS OF THE INVASION DEPTH OF 0-ⅡC TYPE ESOPHAGEAL CANCER

Abstract

Approximately 60% of all superficial esophageal cancers are type 0-Ⅱc lesions, which have varying invasion depths ranging from T1a-EP to T1b-SM. For type 0-Ⅱc lesions, evaluation of the depth of tumor invasion is essential. The first step in determining the depth of invasion is to predict the approximate depth based on routine assessment of lesion morphology, mobility, and other observable features. When an invasion depth of T1a-MM or more is suspected, magnifying endoscopy or endoscopic ultrasound (EUS) is performed to examine the site with marked irregularities of the surface to predict the depth, size and mode of invasion at the deepest point. This approach may not work for cases with microscopic tumor invasion. However, EUS is effective when it is difficult to determine the depth of invasion based on vascular changes, such as lesions showing differences in findings between routine assessment and magnifying endoscopy, lesions with thickening of the depressed area, and type R lesions. Magnifying endoscopy and EUS each have limitations if used alone. Therefore, it is important to examine all findings in a comprehensive manner to ensure diagnostic accuracy.