Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification

Abstract Backgrounds The pharynx has no muscularis mucosae, so it is unclear whether diagnostic techniques used for the esophagus can be applied to the pharynx. This study investigated the usefulness of magnifying endoscopy with narrowband imaging using the Japan Esophageal Society (JES) classificat...

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Main Authors: Hayato Yamaguchi, Takashi Kawai, Masakatsu Fukuzawa, Daiki Nemoto, Yasuyuki Kagawa, Shin Kono, Sakiko Naito, Hiroki Sato, Naoyoshi Nagata, Mitsushige Sugimoto, Kiyoaki Tsukahara, Takao Itoi
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.151
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author Hayato Yamaguchi
Takashi Kawai
Masakatsu Fukuzawa
Daiki Nemoto
Yasuyuki Kagawa
Shin Kono
Sakiko Naito
Hiroki Sato
Naoyoshi Nagata
Mitsushige Sugimoto
Kiyoaki Tsukahara
Takao Itoi
author_facet Hayato Yamaguchi
Takashi Kawai
Masakatsu Fukuzawa
Daiki Nemoto
Yasuyuki Kagawa
Shin Kono
Sakiko Naito
Hiroki Sato
Naoyoshi Nagata
Mitsushige Sugimoto
Kiyoaki Tsukahara
Takao Itoi
author_sort Hayato Yamaguchi
collection DOAJ
description Abstract Backgrounds The pharynx has no muscularis mucosae, so it is unclear whether diagnostic techniques used for the esophagus can be applied to the pharynx. This study investigated the usefulness of magnifying endoscopy with narrowband imaging using the Japan Esophageal Society (JES) classification for predicting the depth of invasion and lymph node metastasis (LNM) in pharyngeal cancer. Methods A total of 123 superficial pharyngeal carcinoma lesions that had been observed preoperatively with magnifying endoscopy with narrowband imaging between January 2014 and June 2021 were analyzed. Predictors of subepithelial invasion (SEP) and LNM were sought based on endoscopic findings, including microvascular morphology, using the JES classification. Results The lesions were divided into carcinoma in situ (n = 41) and SEP (n = 82). Multivariate analysis identified B2–B3 vessels (odds ratio [OR] 6.54, 95% confidence interval [CI] 1.74–24.61, p = 0.005) and a middle/large avascular area (OR 4.15, 95% CI 1.18–14.62, p = 0.027) as independent predictors of SEP. Significant predictors of LNM were protruding type, B2–B3 vessels, middle/large avascular area, SEP, venous invasion, lymphatic invasion, and tumor thickness > 1000 μm. Median tumor thickness increased significantly in the order of B1 < B2 < B3 vessels (B1, 305 μm; B2, 1045 μm; B3, 4043 μm; p < 0.001). The LNM rates for B1, B2, and B3 vessels were 1.6% (1/63), 4.8% (2/42), and 55.6% (10/18), respectively (p < 0.001). Conclusions Magnifying endoscopy with narrowband imaging using the JES classification could predict the depth of invasion in superficial pharyngeal carcinoma. The JES classification may contribute to the prediction of LNM, suggesting that it could serve as an alternative to tumor thickness.
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spelling doaj-art-792e3d2df1eb4ae88676f6e9259c79022025-08-20T01:50:18ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.151Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classificationHayato Yamaguchi0Takashi Kawai1Masakatsu Fukuzawa2Daiki Nemoto3Yasuyuki Kagawa4Shin Kono5Sakiko Naito6Hiroki Sato7Naoyoshi Nagata8Mitsushige Sugimoto9Kiyoaki Tsukahara10Takao Itoi11Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterological Endoscopy Tokyo Medical University Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Otorhinolaryngology, Head, and Neck Surgery Tokyo Medical University Tokyo JapanDepartment of Gastroenterological Endoscopy Tokyo Medical University Hospital Tokyo JapanDepartment of Gastroenterological Endoscopy Tokyo Medical University Hospital Tokyo JapanDepartment of Otorhinolaryngology, Head, and Neck Surgery Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanAbstract Backgrounds The pharynx has no muscularis mucosae, so it is unclear whether diagnostic techniques used for the esophagus can be applied to the pharynx. This study investigated the usefulness of magnifying endoscopy with narrowband imaging using the Japan Esophageal Society (JES) classification for predicting the depth of invasion and lymph node metastasis (LNM) in pharyngeal cancer. Methods A total of 123 superficial pharyngeal carcinoma lesions that had been observed preoperatively with magnifying endoscopy with narrowband imaging between January 2014 and June 2021 were analyzed. Predictors of subepithelial invasion (SEP) and LNM were sought based on endoscopic findings, including microvascular morphology, using the JES classification. Results The lesions were divided into carcinoma in situ (n = 41) and SEP (n = 82). Multivariate analysis identified B2–B3 vessels (odds ratio [OR] 6.54, 95% confidence interval [CI] 1.74–24.61, p = 0.005) and a middle/large avascular area (OR 4.15, 95% CI 1.18–14.62, p = 0.027) as independent predictors of SEP. Significant predictors of LNM were protruding type, B2–B3 vessels, middle/large avascular area, SEP, venous invasion, lymphatic invasion, and tumor thickness > 1000 μm. Median tumor thickness increased significantly in the order of B1 < B2 < B3 vessels (B1, 305 μm; B2, 1045 μm; B3, 4043 μm; p < 0.001). The LNM rates for B1, B2, and B3 vessels were 1.6% (1/63), 4.8% (2/42), and 55.6% (10/18), respectively (p < 0.001). Conclusions Magnifying endoscopy with narrowband imaging using the JES classification could predict the depth of invasion in superficial pharyngeal carcinoma. The JES classification may contribute to the prediction of LNM, suggesting that it could serve as an alternative to tumor thickness.https://doi.org/10.1002/deo2.151JES classificationmagnifying endoscopynarrowband imagingpharyngeal cancertumor thickness
spellingShingle Hayato Yamaguchi
Takashi Kawai
Masakatsu Fukuzawa
Daiki Nemoto
Yasuyuki Kagawa
Shin Kono
Sakiko Naito
Hiroki Sato
Naoyoshi Nagata
Mitsushige Sugimoto
Kiyoaki Tsukahara
Takao Itoi
Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification
DEN Open
JES classification
magnifying endoscopy
narrowband imaging
pharyngeal cancer
tumor thickness
title Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification
title_full Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification
title_fullStr Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification
title_full_unstemmed Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification
title_short Prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the Japan Esophageal Society classification
title_sort prediction of depth of invasion and lymph node metastasis in superficial pharyngeal cancer by magnifying endoscopy using the japan esophageal society classification
topic JES classification
magnifying endoscopy
narrowband imaging
pharyngeal cancer
tumor thickness
url https://doi.org/10.1002/deo2.151
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