Comparison of staging diagnosis by two magnifying endoscopy classification for superficial oesophageal cancer

Background: Due to the possibility of lymph node metastasis, surgical resection is indicated for superficial oesophageal cancer with invasion to a depth greater than the muscularis mucosa. Although two magnifying endoscopy classifications are currently used to diagnose the depth of invasion, which classification is more suitable remains controversial. Aims: To compare and evaluate the clinical outcomes of two classifications for superficial oesophageal squamous cell carcinoma. Methods: This cross-sectional study consists of 44 superficial oesophageal squamous cell carcinoma lesions with magnification image-enhanced endoscopy images. Only magnifying endoscopic images were displayed to two experienced endoscopists who independently diagnosed the depth of invasion according to both classifications. Results: The sensitivity of invasion greater than the muscularis mucosa tended to be higher in Inoue's classification than Arima's classification (78.3 +/- 6.2% vs. 50.0 +/- 3.0%; P = 0.144), whereas the specificity was significantly lower in Inoue's classification than in Arima's classification (61.9 +/- 0.0% vs. 97.6 +/- 3.4%; P=0.043). For both classifications, rates of concordance were 90.9% and 84.4%, and kappa statistics were 0.81 and 0.66, respectively. Conclusions: Our results suggest that Arima's classification is suitable for general screening before treatment to avoid unnecessary surgery. Inoue's classification is appropriate for assessing wide lesion. (C) 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.