TY - JOUR
T1 - Histological features responsible for brownish epithelium in squamous neoplasia of the esophagus by narrow band imaging
AU - Kanzaki, Hiromitsu
AU - Ishihara, Ryu
AU - Ishiguro, Shingo
AU - Nagai, Kengo
AU - Matsui, Fumi
AU - Yamashina, Takeshi
AU - Ohta, Takashi
AU - Yamamoto, Sachiko
AU - Hanaoka, Noboru
AU - Hanafusa, Masao
AU - Takeuchi, Yoji
AU - Higashino, Koji
AU - Uedo, Noriya
AU - Iishi, Hiroyasu
AU - Tomita, Yasuhiko
PY - 2013/2
Y1 - 2013/2
N2 - Background and Aim: Esophageal squamous neoplasias usually appear brown under narrow band imaging as a result of microvascular proliferation, and brownish color changes in the areas between vessels, referred to as brownish epithelium. However, the reasons for the development of this brownish epithelium and its clinical implications have not been fully investigated. Methods: Patients with superficial esophageal neoplasias treated by endoscopic resection were included in the study. Areas of mucosa with brownish and non-brownish epithelia were evaluated histologically. Results: A total of 68 superficial esophageal neoplasias in 58 patients were included in the analysis. Of the 68 lesions, 32 were classified in the brownish epithelium group, and 36 in the non-brownish epithelium group. Brownish epithelium was significantly associated with a diagnosis of high-grade intraepithelial neoplasia or invasive cancer (P<0.0001). Thinning of the keratinous layer, thinning of the epithelium, and cellular atypia were significantly associated with brownish epithelium by univariate analysis, and thinning of the keratinous layer and thinning of the epithelium were confirmed to be independent factors by multivariate analysis. The odds ratios were 9.6 (95% confidence interval: 2.0-46.3) for thinning of the keratinous layer, and 4.6 (95% confidence interval: 1.1-19.4) for thinning of the epithelium. Conclusions: Brownish epithelium is an important finding in the diagnosis of esophageal squamous neoplasia, and may be related to thinning of the keratinous layer, caused by neoplastic cell proliferation, and thinning of the epithelium.
AB - Background and Aim: Esophageal squamous neoplasias usually appear brown under narrow band imaging as a result of microvascular proliferation, and brownish color changes in the areas between vessels, referred to as brownish epithelium. However, the reasons for the development of this brownish epithelium and its clinical implications have not been fully investigated. Methods: Patients with superficial esophageal neoplasias treated by endoscopic resection were included in the study. Areas of mucosa with brownish and non-brownish epithelia were evaluated histologically. Results: A total of 68 superficial esophageal neoplasias in 58 patients were included in the analysis. Of the 68 lesions, 32 were classified in the brownish epithelium group, and 36 in the non-brownish epithelium group. Brownish epithelium was significantly associated with a diagnosis of high-grade intraepithelial neoplasia or invasive cancer (P<0.0001). Thinning of the keratinous layer, thinning of the epithelium, and cellular atypia were significantly associated with brownish epithelium by univariate analysis, and thinning of the keratinous layer and thinning of the epithelium were confirmed to be independent factors by multivariate analysis. The odds ratios were 9.6 (95% confidence interval: 2.0-46.3) for thinning of the keratinous layer, and 4.6 (95% confidence interval: 1.1-19.4) for thinning of the epithelium. Conclusions: Brownish epithelium is an important finding in the diagnosis of esophageal squamous neoplasia, and may be related to thinning of the keratinous layer, caused by neoplastic cell proliferation, and thinning of the epithelium.
KW - Brownish area
KW - Brownish epithelium
KW - Esophageal cancer
KW - Esophageal squamous neoplasia
KW - Narrow band imaging
UR - http://www.scopus.com/inward/record.url?scp=84872791567&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872791567&partnerID=8YFLogxK
U2 - 10.1111/jgh.12059
DO - 10.1111/jgh.12059
M3 - Article
C2 - 23190157
AN - SCOPUS:84872791567
VL - 28
SP - 274
EP - 278
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
SN - 0815-9319
IS - 2
ER -