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ENDOSCOPIC DIAGNOSIS OF INTRAEPITHELIAL SQUAMOUS NEOPLASIA IN HEAD AND NECK AND ESOPHAGEAL MUCOSAL SITES
Author(s) -
Muto Manabu,
Sano Yasushi,
Fujii Satoshi,
Ochiai Atsushi,
Yoshida Shigeaki
Publication year - 2006
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2006.00616.x
Subject(s) - medicine , dysplasia , intraepithelial neoplasia , endoscopic mucosal resection , endoscopy , radiology , epithelial dysplasia , malignant transformation , head and neck squamous cell carcinoma , carcinoma in situ , pathology , carcinoma , head and neck cancer , cancer , prostate
In the multistep process of squamous epithelial carcinogenesis, squamous epithelial dysplasia has been considered to be a preinvasive stage of squamous cell carcinoma. If we could distinguish a dysplasia at high risk, such lesions could be targets for local treatment such as endoscopic mucosal resection to avoid the transformation to invasive carcinoma. Narrow‐band imaging, a new optical technology, is useful to identify the cancerous lesion compared to conventional white light image. In addition, narrow‐band imaging combined with magnifying endoscopy makes it possible to visualize the changes of microvascular architecture occurring in the epithelium. To evaluate whether these endoscopic findings are reliable to diagnose a dysplasia at high risk, a prospective study on the basis of the standards for reporting diagnostic accuracy initiative is needed. If endoscopic assessment of intraepithelial squamous neoplasia is reliable, it would be of benefit to the patients’ outcome and improve cost effectiveness of care because of the avoidance of developing invasive carcinoma and the reduction of unnecessary biopsies.