China: Endocytoscopy as an Effective Screening Tool for Early Esophageal Cancer

A recent study published in Gastroenterology & Endoscopy has suggested that endocytoscopy (ECS) can be used as an effective screening tool for diagnosing early esophageal cancer (EC).

The study showed that the accuracy (95%) and specificity (92%) of endocytoscopy for the observation and diagnosis of early esophageal cancer are very high, comparable to the efficacy of diagnosis after pathological biopsy.

Understanding Esophageal Cancer

Esophageal cancer is a malignant tumor originating from the esophagus. It is the seventh most common cancer and the sixth deadliest type of cancer in the world, posing a serious threat to people's life and health. Unfortunately, esophageal cancer is often found in an advanced stage, with a high fatality rate and poor survival. Therefore, early diagnosis of esophageal cancer is very important for both patients and doctors. Of course, this is not easy for endoscopists because early esophageal cancers are small and often lack typical features.

Challenges in Diagnosis

For a long time, when endoscopists find lesions, they will always take biopsies several times to confirm their judgment. Still, this process may lead to complications such as mucosal bleeding or perforation.

The application of digestive endoscopy is the most extensive and practical in observing and diagnosing various digestive tract diseases. The same is true for esophageal lesions. Of course, the early esophageal cancer diagnosis rate is relatively low through common gastroscopy, and pathological biopsy is always needed for a clear diagnosis.

Advancements in Endocytoscopy

With the continuous improvement of medical equipment for detecting early esophageal cancer, the international community has begun to pay high attention to endoscopic observation at the cell level and gradually reduce the dependence on pathological biopsy. At this point, endocytoscopy came into being. Endocytoscopy can enlarge the level of 520 and observe the changes of cells through special staining methods that do not cause harm, thus enabling early detection and diagnosis of esophageal lesions.

Current Research and Recommendations

At present, there are few studies on the observation and diagnosis of esophageal cancer under endocytoscopy. By summarizing the published articles, we found that the accuracy (95%) and specificity (92%) of endocytoscopy for the observation and diagnosis of early esophageal cancer are very high, which is comparable to the efficacy of diagnosis after pathological biopsy.

Therefore, the observation and diagnosis of esophageal lesions by cell endoscopy is worthy of extensive recommendation and application in clinical practice.

Reference

Lu Wang, Bofu Tang, Feifei Liu, Zhenyu Jiang, Xianmei Meng, The diagnostic utility of endocytoscopy for the detection of esophageal lesions: A systematic review and meta-analysis, Gastroenterology & Endoscopy, 2023, https://doi.org/10.1016/j.gande.2023.01.002.