{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:49:47Z","timestamp":1762051787987,"version":"build-2065373602"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Endocytoscopy (ECS) enables microscopic observation in vivo for the gastrointestinal mucosa; however, there has been no prospective study in which the diagnostic accuracy of ECS for lesions that have not yet undergone histological diagnosis was evaluated. We conducted a surveillance study for patients in a high-risk group of esophageal squamous cell carcinoma (ESCC) and evaluated the in vivo histological diagnostic accuracy of ECS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study was a multicenter prospective study. We enrolled 197 patients in the study between September 1, 2019 and November 30, 2020. The patients first underwent white light imaging and narrow band imaging, and ultra-high magnifying observation was performed if there was a lesion suspected to be an esophageal tumor. Endoscopic submucosal dissection (ESD) was later performed for lesions that were diagnosed to be ESCC by ECS without biopsy. We evaluated the diagnostic accuracy of ECS for esophageal tumorous lesions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>ESD was performed for 37 patients (41 lesions) who were diagnosed as having ESCC by ECS, and all of them were histopathologically diagnosed as having ESCC. The sensitivity [95% confidence interval (CI)] was 97.6% (87.7\u201399.7%), specificity (95% CI) was 100% (92.7\u2013100%), diagnostic accuracy (95% CI) was 98.9% (94.0\u201399.8%), positive predictive value (PPV) (95% CI) was 100% (91.4\u2013100%) and negative predictive value (NPV) (95% CI) was 98.0% (89.5\u201399.7%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>ECS has a high diagnostic accuracy and there were no false positives in cases diagnosed and resected as ESCC. Optical biopsy by using ECS for esophageal lesions that are suspected to be tumorous is considered to be sufficient in clinical practice.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02335-5","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T11:03:06Z","timestamp":1653130986000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Optical biopsy for esophageal squamous cell neoplasia by using endocytoscopy"],"prefix":"10.1186","volume":"22","author":[{"given":"Yoshihiko","family":"Shimoda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Okahara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takakazu","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Ichihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikko","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayoko","family":"Kinowaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayoshi","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiko","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoko","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"2335_CR1","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1111\/jgh.12477","volume":"29","author":"M Takahashi","year":"2014","unstructured":"Takahashi M, Shimizu Y, Ono M, Suzuki M, Omori S, Yoshida T, et al. Endoscopic diagnosis of early neoplasia of the esophagus with narrow band imaging: correlations among background coloration and iodine staining findings. J Gastroenterol Hepatol. 2014;29:762\u20138.","journal-title":"J Gastroenterol Hepatol"},{"key":"2335_CR2","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1038\/ajg.2014.94","volume":"109","author":"Y Nagami","year":"2014","unstructured":"Nagami Y, Tominaga K, Machida H, Nakatani M, Kameda N, Sugimori S, et al. Usefulness of non-magnifying narrow-band imaging in screening of early esophageal squamous cell carcinoma: a prospective comparative study using propensity score matching. Am J Gastroenterol. 2014;109:845\u201354.","journal-title":"Am J Gastroenterol"},{"key":"2335_CR3","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1055\/s-0035-1569644","volume":"48","author":"K Goda","year":"2016","unstructured":"Goda K, Dobashi A, Yoshimura N, Aihara H, Kato M, Sumiyama K, et al. Dual-focus versus conventional magnification endoscopy for the diagnosis of superficial squamous neoplasms in the pharynx and esophagus: a randomized trial. Endoscopy. 2016;48:321\u20139.","journal-title":"Endoscopy"},{"key":"2335_CR4","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1055\/s-2006-944667","volume":"38","author":"H Inoue","year":"2006","unstructured":"Inoue H, Sasajima K, Kaga M, Sugaya S, Sato Y, Wada Y, et al. Endoscopic in vivo evaluation of tissue atypia in the esophagus using a newly designed integrated endocytoscope: a pilot trial. Endoscopy. 2006;38:891\u20135.","journal-title":"Endoscopy"},{"key":"2335_CR5","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1111\/j.1442-2050.2011.01241.x","volume":"25","author":"H Minami","year":"2012","unstructured":"Minami H, Inoue H, Yokoyama A, Ikeda H, Satodate H, Hamatani S, et al. Recent advancement of observing living cells in the esophagus using CM double staining: endocytoscopic atypia classification. Dis Esophagus. 2012;25:235\u201341.","journal-title":"Dis Esophagus"},{"key":"2335_CR6","first-page":"11","volume-title":"Pathology and genetics of tumours of the digestive system: world health organization classification of tumours","author":"HE Gabbert","year":"2000","unstructured":"Gabbert HE, Shimoda T, Hainaut P, Nakamura Y, Field JK, Inoue H. Squamous cell carcinoma of the oesophagus. In: Hamilton SR, Aaltonen LH, editors. Pathology and genetics of tumours of the digestive system: world health organization classification of tumours. Lyon: IARC Press; 2000. p. 11\u20139."},{"key":"2335_CR7","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1136\/gut.47.2.251","volume":"47","author":"RJ Schlemper","year":"2000","unstructured":"Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47:251\u20135.","journal-title":"Gut"},{"key":"2335_CR8","first-page":"176","volume":"49","author":"Y Kumagai","year":"2017","unstructured":"Kumagai Y, Takubo K, Kawada K, Higashi M, Ishiguro T, Sobajima J, et al. A newly developed continuous zoom-focus endocytoscope. Endoscopy. 2017;49:176\u201380.","journal-title":"Endoscopy"},{"key":"2335_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10388-016-0551-7","volume":"14","author":"H Matsubara","year":"2017","unstructured":"Matsubara H, President F, Ando N, et al. Japanese classification of esophageal cancer, 11th edition: part I. Esophagus. 2017;14:1\u201336.","journal-title":"Esophagus"},{"key":"2335_CR10","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1136\/gut.51.1.130","volume":"51","author":"MF Dixon","year":"2002","unstructured":"Dixon MF. Gastrointestinal epithelial neoplasia: Vienna revisited. Gut. 2002;51:130\u20131.","journal-title":"Gut"},{"key":"2335_CR11","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.gie.2005.09.027","volume":"63","author":"Y Shimizu","year":"2006","unstructured":"Shimizu Y, Kato M, Asaka M, Ono Y, Katsurada T, Ono S, et al. Histologic results of EMR for esophageal lesions diagnosed as high-grade intraepithelial squamous neoplasia by endoscopic biopsy. Gastrointest Endosc. 2006;63:16\u201321.","journal-title":"Gastrointest Endosc"},{"key":"2335_CR12","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1055\/s-0032-1325932","volume":"45","author":"Y Mori","year":"2013","unstructured":"Mori Y, Kudo SE, Ikehara N, Wakamura K, Wada Y, Kutsukawa M, et al. Comprehensive diagnostic ability of endocytoscopy compared with biopsy for colorectal neoplasms: a prospective randomized noninferiority trial. Endoscopy. 2013;45:98\u2013105.","journal-title":"Endoscopy"},{"key":"2335_CR13","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1111\/den.12601","volume":"28","author":"Y Mori","year":"2016","unstructured":"Mori Y, Kudo S, Ogawa Y, Wakamura K, Kudo T, Misawa M, et al. Diagnosis of sessile serrated adenomas\/polyps using endocytoscopy (with videos). Dig Endosc. 2016;28:43\u20138.","journal-title":"Dig Endosc"},{"key":"2335_CR14","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1055\/a-1068-9228","volume":"08","author":"S Kataoka","year":"2020","unstructured":"Kataoka S, Kudo SE, Misawa M, Nakamura H, Takeda K, Toyoshima N, et al. Endocytoscopy with NBI has the potential to correctly diagnose diminutive colorectal polyps that are difficult to diagnose using conventional NBI. Endosc Int Open. 2020;08:360\u20137.","journal-title":"Endosc Int Open"},{"key":"2335_CR15","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1053\/j.gastro.2016.07.040","volume":"151","author":"C Katada","year":"2016","unstructured":"Katada C, Yokoyama T, Yano T, Kaneko K, Oda I, Shimizu Y, et al. Alcohol consumption and multiple dysplastic lesions increase risk of squamous cell carcinoma in the esophagus, head, and neck. Gastroenterology. 2016;151:860\u20139.","journal-title":"Gastroenterology"},{"key":"2335_CR16","doi-asserted-by":"publisher","first-page":"19221","DOI":"10.1038\/s41598-020-76309-6","volume":"10","author":"Y Kumagai","year":"2020","unstructured":"Kumagai Y, Yamamoto E, Higashi M, Ishiguro T, Hatano S, Toyomasu Y, et al. Endocytoscopic observation with methylene blue staining for duodenal neoplasms associated with familial adenomatous polyposis. Sci Rep. 2020;10:19221.","journal-title":"Sci Rep"},{"key":"2335_CR17","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1159\/000506930","volume":"14","author":"Y Kumagai","year":"2020","unstructured":"Kumagai Y, Higashi M, Muramatsu S, Mochiki E, Ishida H. Endocytoscopic observation of non-ampullary mucosal duodenal cancer. Case Rep Gastroenterol. 2020;14:156\u201364.","journal-title":"Case Rep Gastroenterol"},{"key":"2335_CR18","doi-asserted-by":"publisher","first-page":"28","DOI":"10.21037\/tgh.2019.11.12","volume":"5","author":"MRA Abad","year":"2020","unstructured":"Abad MRA, Shimamura Y, Fujiyoshi Y, Seewald S, Inoue H. Endocytoscopy: technology and clinical application in upper gastrointestinal tract. Transl Gastroenterol Hepatol. 2020;5:28.","journal-title":"Transl Gastroenterol Hepatol"},{"key":"2335_CR19","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1002\/1097-0142(19950915)76:6<928::AID-CNCR2820760604>3.0.CO;2-5","volume":"76","author":"A Yokoyama","year":"1995","unstructured":"Yokoyama A, Ohmori T, Takahashi H, Maruyama K, Okuyama K, Takahashi H, et al. Successful screening for early esophageal cancer in alcoholics using endoscopy and mucosal iodine staining. Cancer. 1995;76:928\u201334.","journal-title":"Cancer"},{"key":"2335_CR20","first-page":"34785","volume":"S0016\u20135107","author":"M Liu","year":"2020","unstructured":"Liu M, Zhou R, Guo C, Xu R, Liu A, Yang H, et al. Size of Lugol-unstained lesions as a predictor for risk of progression in premalignant lesions of the esophagus. Gastrointest Endosc. 2020;S0016\u20135107:34785\u201394.","journal-title":"Gastrointest Endosc"},{"key":"2335_CR21","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/1471-230X-14-141","volume":"14","author":"K Nagai","year":"2014","unstructured":"Nagai K, Ishihara R, Ishiguro S, Ohta T, Kanzaki H, Yamashina T, et al. Endoscopic optical diagnosis provides high diagnostic accuracy of esophageal squamous cell carcinoma. BMC Gastroenterol. 2014;14:141\u20138.","journal-title":"BMC Gastroenterol"},{"key":"2335_CR22","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1111\/j.1440-1746.2009.06032.x","volume":"25","author":"Y Shimizu","year":"2010","unstructured":"Shimizu Y, Yoshida T, Kato M, Hirota J, Ono S, Nakagawa M, et al. Low-grade dysplasia component in early invasive squamous cell carcinoma of the esophagus. J Gastroenterol Hepatol. 2010;25:314\u20138.","journal-title":"J Gastroenterol Hepatol"},{"key":"2335_CR23","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1097\/CM9.0000000000000623","volume":"133","author":"A El Hajjar","year":"2020","unstructured":"El Hajjar A, Rey J-F. Artificial intelligence in gastrointestinal endoscopy: general overview. Chin Med J (Engl). 2020;133:326\u201334.","journal-title":"Chin Med J (Engl)"},{"key":"2335_CR24","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.gie.2018.07.037","volume":"89","author":"Y Horie","year":"2019","unstructured":"Horie Y, Yoshio T, Aoyama K, Yoshimizu S, Horiuchi Y, Ishiyama A, et al. Diagnostic outcomes of esophageal cancer by artificial intelligence using convolutional neural networks. Gastrointest Endosc. 2019;89:25\u201332.","journal-title":"Gastrointest Endosc"},{"key":"2335_CR25","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1016\/j.gie.2018.11.011","volume":"89","author":"Y Zhu","year":"2019","unstructured":"Zhu Y, Wang Q-C, Xu M-D, Zhang Z, Cheng J, Zhong YS, et al. Application of convolutional neural network in the diagnosis of the invasion depth of gastric cancer based on conventional endoscopy. Gastrointest Endosc. 2019;89:806\u201315.","journal-title":"Gastrointest Endosc"},{"key":"2335_CR26","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1053\/j.gastro.2018.06.037","volume":"155","author":"G Urban","year":"2018","unstructured":"Urban G, Tripathi P, Alkayali T, Mittal M, Jalali F, Karnes W, et al. Deep learning localizes and identifies polyps in real time with 96% accuracy in screening colonoscopy. Gastroenterology. 2018;155:1069\u201378.","journal-title":"Gastroenterology"},{"key":"2335_CR27","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1053\/j.gastro.2016.04.004","volume":"150","author":"M Misawa","year":"2016","unstructured":"Misawa M, Kudo SE, Mori Y, Nakamura H, Kataoka S, Maeda Y, et al. Characterization of colorectal lesions using a computer aided diagnostic system for narrow band imaging endocytoscopy. Gastroenterology. 2016;150:1531\u20132.","journal-title":"Gastroenterology"},{"key":"2335_CR28","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1055\/s-0042-113609","volume":"48","author":"Y Mori","year":"2016","unstructured":"Mori Y, Kudo SE, Chiu PW, Singh R, Misawa M, Wakamura K, et al. Impact of an automated system for endocytoscopic diagnosis of small colorectal lesions: an international web-based study. Endoscopy. 2016;48:1110\u20138.","journal-title":"Endoscopy"},{"key":"2335_CR29","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/s10388-018-0651-7","volume":"16","author":"Y Kumagai","year":"2019","unstructured":"Kumagai Y, Takubo K, Kawada K, Aoyama K, Endo Y, Ozawa T, et al. Diagnosis using deep-learning artificial intelligence based on the endocytoscopic observation of the esophagus. Esophagus. 2019;16:180\u20137.","journal-title":"Esophagus"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02335-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-022-02335-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02335-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T11:03:20Z","timestamp":1653131000000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-022-02335-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,21]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["2335"],"URL":"https:\/\/doi.org\/10.1186\/s12876-022-02335-5","relation":{},"ISSN":["1471-230X"],"issn-type":[{"type":"electronic","value":"1471-230X"}],"subject":[],"published":{"date-parts":[[2022,5,21]]},"assertion":[{"value":"21 November 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The present study was a multicenter, exploratory, prospective study conducted at Hokkaido University Hospital and Keiyukai Daini Hospital. All personnel in this study conducted the study in compliance with the \"Declaration of Helsinki (revised October 2013)\". The protocol was approved by the ethics review committee at Hokkaido University Hospital (No. 018-0373, June 4, 2019) and registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000037383). We informed consent was obtained from all the participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no conflict of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"259"}}