Diagnostic Performance of a Novel Ultra-Thin Endoscopy under Narrow-Band Imaging for Superficial Squamous Cell Carcinoma of the Pharynx and Esophagus.

Simple Summary: A newly developed ultra-thin endoscope (UTE) provides higher-resolution images, allowing for the evaluation of microvascular patterns. This prospective study aimed to demonstrate the diagnostic performance of UTE for superficial squamous cell carcinoma (SSCC) in the pharynx and esophagus. The Japan Esophageal Society classification is the most common diagnostic system for SESCC. This system requires a precise evaluation of microvessels under magnification with narrow-band imaging. We confirmed that the UTE exhibited sufficient diagnostic performance for the detection and diagnosis of SSCC compared to magnifying endoscopy. The study results showed that most lesions can be accurately diagnosed with high confidence without magnification (i.e., UTE), and the confidence level did not improve, even when the lesion was observed under magnification. UTE, which provides higher-resolution images, can be a reliable tool for the screening or surveillance of SSCC in the pharynx and esophagus. This study aimed to evaluate the diagnostic utility of the ultra-thin endoscope (UTE) for superficial squamous cell carcinoma (SSCC) compared to magnifying endoscopy (ME) under narrow-band imaging. Participants underwent endoscopic examination, and images of pharyngeal and esophageal SCCs, as along with suspicious SSCC lesions, were collected using UTE and ME on the same day. Three image catalogs (UTE, ME-1, and ME-2) were created and reviewed by three expert endoscopists. ME-1 and ME-2 contained the same endoscopic images. The primary endpoint was the intra-observer agreement for diagnosing SCC. Eighty-six lesions (SCC = thirty-nine, non-SCC = forty-seven) in 43 participants were identified. The kappa values for the intra-observer agreement between UTE and ME-1 vs. the control (ME-1 vs. ME-2) were 0.74 vs. 0.84, 0.63 vs. 0.76, and 0.79 vs. 0.88, respectively. The accuracies for diagnosing SCC by UTE and ME-1 were 87.2% vs. 86.0%, 78.0% vs. 73,2%, and 75.6 vs. 82.6%, respectively, with no significant differences (p > 0.05). The rates of lesions that were diagnosed with confidence by UTE and ME-1 were 30.2% vs. 27.9%, 55.8% vs. 62.8%, and 58.1% vs. 55.8%, respectively. UTE demonstrates substantial diagnostic performance for SSCC in the pharynx and esophagus. [ABSTRACT FROM AUTHOR]