Diagnostic Accuracy of JES Classification for Prediction of Invasion Depth in Superficial Esophageal Squamous Carcinoma: Meta-Analysis

Prediction of the depth of invasion in superficial oesophageal squamous carcinoma (SESC) is an important factor for choosing the treatment.Recently, the Japan Esophageal Society (JES) designed a magnifying endoscopy classification based on the Inoue and Arima classifications.The aim of this study was to conduct a meta-analysis of the published literature on JES classification.Meta-Disc version 1.4, Review Manager 5.4 as well as stata 14.0 were used.The analysis combined sensitivity and specificity with the respective 95% CI, to draw a summary receiver operating characteristic curve (SROC), and estimated the area under curve (AUC) for overdiagnosis and underdiagnosis for each type B. Eight studies were included in the meta-analysis comprising 1279 patients.Type B1 has high sensitivity (0.86, 95%CI: 0.83-0.88)and specificity (0.84, 95%CI: 0.81-0.88)for the prediction of EP/LPM classifications.The AUC was calculated to be 0.92 with a high proportion of underdiagnosis (17%).The sensitivity and specificity of type B2 were 0.66 (95% CI, 0.6-0.72)and 0.84 (95% CI, 0.82-0.86)respectively.The overdiagnosis and underdiagnosis of type B2 were 14% and 39%.Type B3, sensitivity was low (0.49, 95% CI: 0.41-0.56),with high specificity and AUC (specificity: 0.99; AUC: 0.95).JES classification is a useful and reliable modality for predicting the depth of invasion of SESC, but other modalities should be considered for additional assessment when type B2 is detected.