Narrow-Band Imaging Magnifying Endoscopy versus Lugol Chromoendoscopy with Pink-Color Sign Assessment in the Diagnosis of Superficial Esophageal Squamous Neoplasms: A Randomised Noninferiority Trial

Figure 1

A representative lesion of superficial esophageal squamous cell carcinoma. (a) A flat-type lesion of reddish color could be observed at the two to seven o’clock position in the middle esophagus. (b) The lesion was clearly visualized as a 30 mm wide brownish area by using nonmagnifying endoscopy with narrow-band imaging. (c) Narrow-band imaging magnifying endoscopy shows an intervascular background coloration and increase in the number of abnormal microvessels (i.e., proliferation) in the tumor area compared with the normal area. Abnormal microvessels with morphological changes of dilation, tortuosity, change in caliber, and various shapes compared with normal intrapapillary capillary loops are also seen (white arrows). (d) On Lugol chromoendoscopy, the lesion is visualized as a Lugol-voiding area with a pink-color sign at 3 min after spraying the iodine solution. The lesion was removed by endoscopic submucosal dissection, and the histology was squamous cell carcinoma invading up to the lamina propria mucosae.

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