Endoscopic signs of early esophagogastric junction cancer. (The experience of the P.A. Herzsen Moscow Oncology Research Institute)

Objective. To investigate the endoscopic characteristics of early esophagogastric junction cancer in order to improve diagnosis and optimize treatment options. Material and methods. The analysis of clinical, morphological and instrumental data of 66 patients with histologically confirmed early esophagogastric junction cancer (Tis-T1N0M0) and 128 patients with non-tumor pathology of this anatomical area was carried out. All patients underwent high-resolution video oesophagogastroduodenoscopy, including 38 patients with early esophagogastric junction cancer and 55 patients with non–tumor pathology — with examination in a narrow-band imaging with dual focus (NBI Dual Focus). Results. The median tumor size was 14.0 mm. The sensitivity, specificity, and accuracy of the white light imaging were 37.9%, 100%, and 78.9%, respectively. The sensitivity, specificity, and accuracy of the examination in the narrow-spectrum mode with close focus were 81.6%, 92.7%, and 88.2%, respectively. The tumor size of more than 21 mm, the length of the tumor along the circumference of ½ and more, tissue fragmentation during biopsy and independent bleeding are statistically significant predictors of invasion of the esophagogastric junction cancer into the submucosal layer. Conclusion. Specific endoscopic signs of early esophagogastric junction cancer were revealed in a narrow-band imaging with dual focus. The high diagnostic significance of a narrow-band imaging with dual focus in the diagnosis of early esophagogastric junction cancer has been confirmed. Predictors of tumor invasion into the submucosa have been studied.