EVALUATION OF THE INTEROBSERVER CONCORDANCE OF THE ENDOSCOPIC CLASSIFICATION OF INTRAPAPILLARY CAPILLARY LOOPS FOR ESOPHAGEAL SQUAMOUS CELLS CARCINOMA OF THE JAPAN ESOPHAGEAL SOCIETY

Aims:

Endoscopic evaluation of superficial esophageal squamous cancer (ESCC) is crucial to estimate the invasion depth and decide the most appropriate therapeutic strategy. Recently, the JES published a new magnifying endoscopic (ME) classification to predict the invasion depth of SESCC based on microvessel morphology, with a reported accuracy of up to 90%. The objective of this study was to evaluate the inter and intra-observer agreement of the JES classification in a Western oncological center.

Methods:

Images from 30 lesions with suspected ESCC were accessed by ten endoscopists according to the JES classification. Five observers were familiar with the new JES classification and had performed over 100 ME-BLI examinations, and five observers had limited experience with ME-BLI and/or JES classification.

Results:

Overall interobserver agreement of JES classification was substancial (0.61). Kappa level was 0.46 (moderate agreement) among Experienced endoscopists, and 0.51 (moderate agreement) among non-experienced. Agreement was poorer in B1/B2 lesions and there was a trend towards overstaging the lesions.

Conclusions:

Our study was the first to evaluate the interobserver concordance of the endoscopic classification of intrapapillary capillary loops for esophageal cells carcinoma of Japan Esophageal Society in a Western center. We demonstrated only a moderate interobserver agreement in both experienced and inexperienced endoscopist. Our results differ from what was observed in eastern studies and may reflecte the learning curve in the interpretation of IPCL images.