There are many cases which developed recurrence after esophagectomy for superficial esophageal carcinoma. In order to identify clinical features of ideal target of early detection of esophageal carcinoma 160 cases of superficial cancer were analyzed.
1. Depth of tumor invasion and incidence of recurrence: Lymph node metastases among mucosal carcinomas were 12% and five-year-survival rate of 13 cases was 100%. There found no recurrence among them. Lymph node metastases among submucosal carcinomas were 38% and 58% of those with lymph node metastases developed recurrence. Five-year-survival rate of submucosal carcinoma cases was 56%.
2. Gross findings of intraepithelial or mucosal carcinoma: Revised endoscopic classification of superficial esophageal carcinoma was composed of 1) O-I (superficial and protruded type), 2) O-II (superficial and flat type), 3) O-III (superficial and excavated type) and 4) O-V (superficial and unclassified type) . O-II type could be classified into a) II. (slightly elevated), b) II, (flat) and c) II, (slightly depressed) types. Ninety-six percent of intraepithelial or mucosal carcinomas were classified into O-II type (II, , 4, II, 16, II, 9) . Eighty-eight percent of submucosal carcinomas were classified into O-I, O-III and O-V.
3. Screening of O-II type lesions: Endoscopy was most successful in detection of O-II type lesions and it was facilitated by endoscopic staining methods.
Conclusion: Intraepithelial or mucosal carcinomas were estimated as ideal target for early detection of esophageal carcinoma considering their excellent prognosis. They could be identified as O-II type lesions at endoscopy. It was difficult to detect O-II lesions even by endoscopy, but endoscopic staining facilitated their detection.
