AB分型联合Arima分型对食管表浅鳞状细胞癌浸润深度判定的价值

Value of AB classification combined with Arima classification for determining the invasion depth of superficial esophageal squamous cell carcinoma

摘要:

目的 探讨AB分型联合Arima分型预测浅表食管鳞状细胞癌（superficial esophageal squamous cell carcinomas，SESCC）浸润深度的临床价值。方法 2017年7月至2022年12月期间在宁波市医疗中心李惠利医院及江苏省中医院接受内镜黏膜下剥离术治疗且鳞状上皮乳头内毛细血管袢（intra‑epithelial papillary capillary loops，IPCL）AB分型为B2型的患者（76处SESCC病变）纳入回顾性研究，根据Arima分型规则对IPCL进行二次分类，以病理判定的浸润深度为金标准，分析B2型联合Arima分型对SESCC浸润深度预测的敏感度、特异度、阳性预测值和阴性预测值。结果 76处病变中，31处（40.79%）浸润黏膜肌层（T1a‑MM）或黏膜下层浅层（T1b‑SM1），B2型IPCL预测T1a‑MM/T1b‑SM1 SESCC的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为70.45%（31/44）、79.64%（176/221）、40.79%（31/76）、93.12%（176/189）、78.11%（207/265）。对病变的IPCL进行Arima分型后，B2‑4ML型、B2‑AVA‑4M型IPCL预测T1a‑MM/T1b‑SM1 SESCC的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为61.36%（27/44）、88.24%（195/221）、50.94%（27/53）、91.98%（195/212）、83.77%（222/265）和38.64%（17/44）、94.57%（209/221）、58.62%（17/29）、88.56%（209/236）、85.28%（226/265）。结论 B2型IPCL联合Arima分型可以提高对T1a‑MM/T1b‑SM1 SESCC的诊断准确性。

Abstract:

Objective To investigate the clinical value of AB classification combined with Arima classification for predicting the invasion depth of superficial esophageal squamous cell carcinomas (SESCC). Methods From July 2017 to December 2022, 76 cases of SESCC receiving endoscopic submucosal dissection and intra-epithelial papillary capillary loops (IPCL) AB classification as type B2 in Ningbo Medical Center Lihuili Hospital and Jiangsu Province Hospital of Chinese Medicine were included in the study. IPCL was reclassified according to Arima classification. The depth of infiltration determined by pathology was the gold standard. The sensitivity, the specificity, the positive predictive value and the negative predictive value of B2-Arima combined classification in predicting the invasion depth of SESCC were analyzed. Results In the 76 cases of type B2 IPCL lesions, 31 cases (40.79%) were T1a-MM/T1b-SM1 SESCC. The sensitivity, the specificity, the positive predictive value, the negative predictive value and the diagnostic accuracy of type B2 IPCL to predict T1a-MM/T1b-SM1 SESCC were 70.45% (31/44), 79.64% (176/221), 40.79% (31/76), 93.12% (176/189), and 78.11% (207/265), respectively. After Arima classification, the above corresponding indicators of type B2-4ML and type B2-AVA-4M IPCL in predicting T1a-MM/T1b-SM1 SESCC were 61.36% (27/44), 88.24% (195/221), 50.94% (27/53), 91.98% (195/212), 83.77% (222/265) and 38.64% (17/44), 94.57% (209/221), 58.62% (17/29), 88.56% (209/236), 85.28% (226/265), respectively. Conclusion B2 IPCL combined with Arima classification can improve the diagnostic accuracy of T1a-MM/T1b-SM1 ESSCC.