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Monitoring Functionality and Morphology of Vasculature Recruited by Factors Secreted by Fast-growing Tumor-generating Cells
Published on: November 23, 2014
Size and Macroscopic Type of Type B2 Vessel Areas in JES Classification for Predicting Invasion Depth: A Multicenter
Masao Yoshida1,2, Yuji Urabe3, Tomohiro Kadota4
1Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
Summary
A new B2 vessel area (B2VA) based method did not improve diagnostic accuracy for predicting esophageal squamous cell carcinoma invasion depth compared to the standard Japan Esophageal Society classification. This finding is crucial for accurate staging of ESCC.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Accurate assessment of tumor invasion depth is critical for staging and treatment planning in esophageal squamous cell carcinoma (ESCC).
- The Japan Esophageal Society (JES) classification is the standard for evaluating invasion depth, but its accuracy for specific vessel involvement, like B2 vessels, can be limited.
- The B2 vessel area (B2VA) and macroscopic tumor type are potential factors influencing invasion depth.
Purpose of the Study:
- To evaluate if incorporating B2VA size and macroscopic tumor type enhances diagnostic performance in predicting ESCC invasion depth.
- To compare the accuracy of a novel B2VA-based classification system against the standard JES classification for ESCC with B2 vessel involvement.
Main Methods:
- A prospective study enrolled 136 ESCC cases with B2 but not B3 vessel involvement.
- Tumor invasion depth was assessed using both the standard JES classification and a B2VA-based method categorizing lesions by B2VA size (narrow/wide) and macroscopic type.
- Diagnostic accuracy and positive likelihood ratios (+LRs) were calculated, with histopathological confirmation obtained post-endoscopic resection or esophagectomy.
Main Results:
- The B2VA-based evaluation showed an overall diagnostic accuracy of 50.0%, compared to 49.3% for the standard JES evaluation (p=1.00).
- B2VA size correlated with pathological invasion depth, with median sizes of 3mm (pEP/LPM), 5mm (pMM/SM1), and 10mm (pSM2-3).
- Specific B2VA features like B2-narrow (+LR 2.26) and B2-wide (+LR 3.45) showed predictive value, with a combination of B2-wide and type 0-I demonstrating the highest prediction for pSM2-3 (+LR 9.75).
Conclusions:
- The B2VA-based evaluation, while showing some predictive value for specific features, did not significantly improve overall diagnostic accuracy for predicting invasion depth in ESCC with B2 vessels compared to the standard JES classification.
- Further refinement of endoscopic assessment methods may be needed to enhance diagnostic precision for ESCC invasion depth.
