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Endoscopic features of superficial esophageal squamous cell carcinoma in patients with very low risk factors (female, non-drinking, and non-smoking): a case-control study

Dig Dis. 2021 Mar 22. doi: 10.1159/000516021. Online ahead of print.

ABSTRACT

BACKGROUND: Although esophageal squamous cell carcinoma is more likely to develop in patients with any risk factor (male, drinking, or smoking), it is sometimes detected in patients with very low risk factors (female, non-drinking, and non-smoking). We examined the endoscopic features of superficial esophageal squamous carcinoma in patients with very low risk factors.

METHODS: In this single-center case-control study, 666 patients with 666 superficial esophageal squamous carcinoma lesions were divided into 2 groups: those with very low risk factors (very-low-risk group, n = 34) and those with any risk factors (any-risk group, n = 632). After case-control selection at a 1:5 ratio, the very-low-risk group comprised 34 patients and the any-risk group comprised 170 patients. We compared the baseline characteristics, endoscopic findings, and treatment results (including pathological diagnosis) between the two groups.

RESULTS: There were no statistically significant differences between the two groups in age, tumor size, tumor location, tumor morphology, or treatment results (including tumor depth and lymphovascular invasion). A longitudinal lesion with an attachment of white keratinized epithelium was more likely to be detected in the very-low-risk group than any-risk group (61.8% versus 17.6%, respectively; P < 0.001).

CONCLUSIONS: Esophageal squamous cell carcinoma in patients with very low risk factors is rare but can be encountered in daily practice. A longitudinal lesion with an attachment of white keratinized epithelium is its main characteristic, which is slightly different from that of patients with any risk factors.

PMID:33752198 | DOI:10.1159/000516021

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