ArticleWorld journal of gastrointestinal oncology2025
Unraveling the characteristics of early esophageal neuroendocrine carcinoma using multi-model endoscopy: A retrospective study of serial cases.
Article in World journal of gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEarly esophageal neuroendocrine carcinoma (E-NEC) is a rare but aggressive malignancy with poorly understood endoscopic features. Despite advancements in multi-model endoscopy, including white light endoscopy, magnifying endoscopy narrow-band imaging (NBI), and endoscopic ultrasonography (EUS), the diagnostic characteristics of early E-NEC remain unclear. Comprehensive evaluation using these techniques can improve early detection and guide clinical management. This study aimed to investigate the endoscopic features of early E-NEC using multiple imaging modalities. We hypothesized that specific endoscopic patterns, such as irregular microvascular morphology or signs of submucosal invasion, could reliably distinguish early E-NEC from other esophageal lesions.
aimTo characterize early E-NEC using multi-model endoscopy and identify diagnostic endoscopic features.
methodsClinical data of four patients with esophageal submucosal lesions identified by gastroscopy and pathologically diagnosed as E-NEC in the Department of Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine between January 2020 and August 2024 were retrospectively analyzed, and their manifestations under multi-model endoscopy were observed. Grayscale values of ultrasound images in three patients with E-NEC and eight with esophageal leiomyoma were calculated using Image J software and compared using the Mann-Whitney
resultsAmong the four patients with early E-NEC, two were males and two were females, with ages ranging from 60-70 years. White light endoscopy revealed three patients with mild local ulceration on the lesion surface. NBI images were available in two patients, revealing the intraepithelial papillary capillary loop of B1-B2 and B2 types. EUS was performed in three patients, all showing solitary hypoechoic lesions originating from the muscularis mucosa/mucosal muscular layer or submucosa; peripherally enlarged lymph node was observed in one patient. Average grayscale value of EUS images for early E-NEC (
conclusionEndoscopic features of early E-NEC differ from those of esophageal leiomyoma, including NBI imaging, lymph node metastasis, and a notably higher echo intensity on EUS.
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