Sa1306 VIRTUAL CHROMOENDOSCOPY UNDER LESS-AIR CONDITION IMPROVES THE VISIBILITY OF SURPERFICIAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA

The current virtual chromoendoscopy (VC) cannot completely detect superficial squamous cell carcinoma (SCC) in the esophagus, despite its development in the recent years. Thus, in this study, we aimed to elucidate the efficacy of air control to improve the visibility of esophageal SCC. This retrospective study included a total of 104 esophageal SCCs identified between April 2017 and January 2019 in the Department of Gastrointestinal Oncology, Osaka International Cancer Institute. Video images of VC including narrow band imaging or blue laser imaging under both less-air (Figure 1) and standard-air conditions (Figure 2) were recorded digitally. Videos were evaluated by five endoscopists. Relative visibility between less-air and standard-air conditions of the brownish area, brownish color change of the epithelium, and dilated intrapapillary capillary loop (IPCL) were graded as 5 (definitely better under less-air condition) to 1 (definitely worse under less-air condition), with 3 indicating average visibility (equivalent to standard-air observation). The mean (standard deviation) visibility score of the brownish area, brownish color change of the epithelium, and dilated IPCLs under less-air condition were 3.96 (0.59), 3.73 (0.58), and 4.14 (0.60), respectively, which were significantly better than that under standard-air condition (p<0.0001). Esophageal SCC evaluated as ≥4 in the mean visibility score of the brownish area, brownish color change of the epithelium, and dilated IPCLs accounted for 51% (53/104 lesions), 35% (36/104 lesions), and 66% (69/104 lesions), respectively. VC with less air improved the visibility of esophageal SCC compared to VC with standard air. This technique may facilitate the detection of esophageal SCC.Figure 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)