The investigators clarified the microvascular architecture of superficial esophageal carcinoma.
They reported their results in the May issue of Endoscopy.
Two surgically resected specimens of superficial esophageal cancer were observed under stereoscopic microscopy with Microfil injection.
In addition, in the histological investigation, the caliber of the vessels at the surface of the tumor was measured.
Ultra-high magnification endoscopy was conducted before treatment in 82 patients with superficial esophageal neoplasms.
The depth of tumor penetration of superficial esophageal carcinoma was classified into 4 categories: m1 to m3 (mucosal cancer) and sm (submucosal cancer).
| The researchers were able to visualize the intrapapillary capillary loops.
| Endoscopy |
By observing the normal esophageal mucosa under a stereoscopic microscope and an ultra-high magnification endoscope, the researchers were able to visualize the intrapapillary capillary loops (IPCL).
In cancer lesions, they observed characteristic changes in the superficial microvascular architecture, according to the depth of tumor invasion.
In m1 invasion, there was dilatation of the IPCL; in m2 invasion, there was dilatation and elongation of the IPCL.
The authors found that, in m3 invasion, there was a mixed appearance of the IPCL and tumor vessels; and in sm invasion, complete replacement by tumor vessels.
Ultra-high magnification endoscopic observation before treatment showed a rate of agreement between histological depth of invasion and magnified appearance of 83%, for which satisfactory pictures were obtained.
The histological investigation showed the mean caliber of the IPCL of the m1 cancer lesions (12.9 µm) to be significantly greater than that of the normal esophageal mucosa (6.9 µm).
Author Y. Kumagai, of the Tokyo Medical and Dental University School of Medicine, concluded on behalf of the group, "Observation of the microvascular architecture of superficial esophageal carcinoma is useful in the diagnosis of the depth of invasion."