Color information from linked color imaging is associated with invasion depth and vascular diameter in superficial esophageal squamous cell carcinoma.

Kobayashi K1, Miyahara R2, Funasaka K2, Furukawa K2, Sawada T1, Maeda K1, Yamamura T1, Ishikawa T2, Ohno E2, Nakamura M2, Kawashima H2, Nakaguro M3, Okumura Y3, Hirooka Y1, Fujishiro M2.

Dig Endosc. 2019 Jun 20. doi: 10.1111/den.13469.

Objectives: Accurate diagnosis of invasion depth is important for reliable treatment of esophageal squamous cell carcinoma, but it is limited to the muscularis mucosae to slight submucosal invasion (MM/SM1). The diagnostic accuracy of invasion depth is unsatisfactory and remains to be improved. We aimed to investigate the association between the color of the superficial esophageal squamous cell carcinoma and invasion depth using linked color imaging (LCI) under light-emitting diode (LED) light sources.

Methods: Lesions diagnosed as superficial esophageal squamous cell carcinoma were observed using white light imaging and then by LCI. The color values were calculated using Commission international de l’eclariage – Lab* color space, and the color difference was calculated according to invasion depth. The vascular diameters and vascular angles of the intrapapillary capillary loops were pathologically analyzed. Their correlation with mucosal color was also investigated by LCI.

Results: In all, 52 lesions from 48 patients were analyzed. On the basis of invasion depth, the color difference between the normal mucosa and the lesion was larger in the MM/SM1 or deeper group than in the epithelium and the lamina propria mucosa (EP/LPM) group using LCI (P = 0.025). The vascular diameter was positively correlated with the b* color value (correlation coefficient = 0.302, P = 0.033).

Conclusion: Observation using LCI under LED light sources may improve the endoscopic diagnosis of the invasion depth of superficial esophageal squamous cell carcinoma. Further research is needed to validate its usefulness. This article is protected by copyright. All rights reserved.

1 Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan
2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
3 Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan