<aside> 📘 Prediction of the invasion depth of superficial squamous cell carcinoma based on microvessel morphology: magnifying endoscopic classification of the Japan Esophageal Society, 2017
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| Superficial Esophageal Squamous Cell Carcinoma (SESCC) | Depth | Lymph Node Metastasis Rate (%) | Indication of Endoscopic Resection (ER) |
|---|---|---|---|
| T1a, Tumor invades epithelium mucosa (M) | EP (Carcinoma in situ) | 0–3.3 | Indicative |
| LPM (Lamina propria mucosa) | |||
| MM (Lamina muscularis mucosa) | 0–12.2 | Relative | |
| T1b, Tumor invades submucosa (SM) | SM1 (Tumor invades the submucosa to a depth of ≤ 200 µm from the MM) | 8–26.5 | Relative |
| - SM2 (Tumor invades the submucosa to a depth > 200 µm) | 22–61 | Contraindication |
The classification focuses on the morphology of microvessels within the squamous mucosal surface, known as intrapapillary capillary loops (IPCL), categorizing them based on the presence of morphological.
The evaluation is under magnifying endoscopy.
| Type of Vessels | Definition | Invasion Depth | Histology |
|---|---|---|---|
| A | Normal IPCL or abnormal microvessels without severe irregularity | No invasion | Normal epithelium, inflammation, and LGIN |
| B1 | Type B vessels with a loop-like formation | T1a-EP or T1a-LPM | HGIN and invasive SCC |
| B2 | Type B vessels without a loop-like formation | T1a-MM or T1b-SM1 | HGIN and invasive SCC |
| B3 | Highly dilated vessels which calibers appear to be more than three times that of usual B2 vessels. | T1b-SM2 or deeper | HGIN and invasive SCC |
<aside> 💡 LGIN: low grade intraepithelial neoplasm
HGIN: high grade intraepithelial neoplasm
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| AVA Size | Surrounding Vessel Type | Suggested Histological Invasion Depth |
|---|---|---|
| Any size | B1 | T1a-EP or T1a-LPM SCC |
| Middle | B2 or B3 | T1a-MM or T1b-SM1 SCC |
| Large | B2 or B3 | T1b-SM2 SCC |