Tumour type, length predict submucosal fibrosis in superficial squamous oesophageal neoplasia
A depressed tumour type and a length of >20 mm predict submucosal fibrosis in superficial squamous oesophageal neoplasia (SSEN), according to a recent study.
Multivariate logistic regression analysis showed that a depressed tumour type (vs nondepressed type; hazard ratio [HR], 12.820; 95 percent CI, 2.506–65.456; p=0.002) and tumour length >20 mm (HR, 6.056; 1.129–32.492; p=0.036) significantly and independently predicted endoscopic submucosal fibrosis.
Moreover, receiving endoscopic submucosal dissection (ESD) right after diagnosis helped avoid submucosal fibrosis, as undergoing the operation >21 days after initial biopsy also increased the risk of developing endoscopic submucosal fibrosis (HR, 10.214; 2.021–51.630; p=0.005).
While the presence of endoscopic submucosal fibrosis did not appear to have an effect on the overall resection rate, the severity of submucosal fibrosis showed a significant and positive association with immediate bleeding rate (severe vs no fibrosis: 100 percent vs 66.7 percent; p=0.018). In addition, one patient with severe submucosal fibrosis showed perforation, while no other cases were observed.
Mean procedure time was also affected by the degree of submucosal fibrosis, such that those with no and mild vs severe fibroses had significantly shorter procedure times (59.4 and 79.8 vs 150.0 minutes; p<0.001 and p=0.008, respectively).
For the present study, researchers retrospectively analysed 41 SSEN patients who received ESD and identified endoscopic and pathological factors associated with submucosal fibrosis. Masson’s trichrome staining was used to assess endoscopic submucosal fibrosis.