Curriculum for optical diagnosis of esophageal neoplasia and precursor lesions: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Roos E. Pouw; Bas L. A. M. Weusten; Jacques J.H.G.M. Bergman; Raf Bisschops; Emmanuel Coron; Pieter Dewint; Peter Elbe; Vicente Lorenzo-Zúñiga; Marcus Hollenbach; Maximilien Barret; Franz L. Dumoulin; Wladyslaw Januszewicz; Anastasios C. Manolakis; Roberta Maselli; Adolfo Parra-Blanco; Stefan Seewald; Vladyslav Yakovenko; Tony C. Tham

doi:10.1055/a-2662-7978

Endoscopy, Table of Contents

Endoscopy
DOI: 10.1055/a-2662-7978

Position Statement

Curriculum for optical diagnosis of esophageal neoplasia and precursor lesions: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Roos E. Pouw

¹Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands (Ringgold ID: RIN8125)

,

Bas L. A. M. Weusten

¹Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands (Ringgold ID: RIN8125)

²Department of Gastroenterology and Hepatology, St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands

,

Jacques J.H.G.M. Bergman

³Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands (Ringgold ID: RIN1209)

,

Raf Bisschops

⁴Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium

,

Emmanuel Coron

⁵Department of Gastroenterology and Hepatology, University Hospital of Geneva (HUG), Geneva, Switzerland (Ringgold ID: RIN27212)

,

Pieter Dewint

⁶Department of Gastroenterology, Algemeen Ziekenhuis (AZ) Oostende, Ostende, Belgium (Ringgold ID: RIN81800)

⁷Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium (Ringgold ID: RIN60202)

,

Peter Elbe

⁸Department of Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden

⁹Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

,

Vicente Lorenzo-Zúñiga

¹⁰Department of Gastroenterology, Hospital Universitario y Politécnico La Fe/IISLaFe, Valencia, Spain (Ringgold ID: RIN16273)

,

Marcus Hollenbach

¹¹Clinic of Gastroenterology, Endocrinology and Infectious Diseases, Marburg University, Marburg, Germany (Ringgold ID: RIN9377)

,

Maximilien Barret

¹²Department of Gastroenterology and Hepatology, Cochin Hospital Paris, Paris, France

,

Franz L. Dumoulin

¹³Department of Medicine and Gastroenterology, Gemeinschaftskrankenhaus Bonn, Bonn, Germany

,

Wladyslaw Januszewicz

¹⁴Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland (Ringgold ID: RIN49585)

¹⁵Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland (Ringgold ID: RIN37802)

,

Anastasios C. Manolakis

¹⁶Department of Gastroenterology, University Hospital of Larisa, Larisa, Greece (Ringgold ID: RIN393317)

,

Roberta Maselli

¹⁷Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Ringgold ID: RIN437807)

¹⁸Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Ringgold ID: RIN9268)

,

Adolfo Parra-Blanco

¹⁹NIHR Nottingham Digestive Diseases Biomedical Research Unit City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom (Ringgold ID: RIN9820)

,

Stefan Seewald

²⁰Gastroenterology Center, Klinik Hirslanden, Zurich, Switzerland

,

Vladyslav Yakovenko

²¹Gastroenterology, Bogomolets National Medical University, Kyiv, Ukraine (Ringgold ID: RIN123498)

,

Tony C. Tham

²²Division Of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland

› Author Affiliations

Abstract

Main statements

Pre-adoption

Endoscopists performing upper gastrointestinal (UGI) endoscopy should train to recognize the appearance of early esophageal cancer and its precursor lesions, for Barrett neoplasia and for squamous neoplasia, to improve detection rates.

Every endoscopist should have achieved competency in UGI endoscopy before commencing training in optical diagnosis in the UGI tract, and this requires personal experience of 300 UGI endoscopies and meeting the ESGE quality measures for UGI endoscopy.

Training

Endoscopists should undertake interactive training courses to improve diagnostic accuracy for esophageal preneoplastic and neoplastic lesions.

Endoscopists should train with the Barrett’s Oesophagus-Related Neoplasia (BORN) module to improve detection and delineation for early Barrett’s esophagus-related neoplasia.

Endoscopists should train in using the Prague classification to describe the circumferential and maximal extent of Barrett epithelium above the gastroesophageal junction.

Endoscopists should train in using the Paris classification to describe suspected neoplastic lesions within both Barrett and squamous epithelium.

Endoscopists should train in using virtual chromoendoscopy to assess both mucosal and vascular patterns in potentially neoplastic lesions in Barrett epithelium as being regular or irregular.

When using acetic acid chromoendoscopy for Barrett’s esophagus inspection, endoscopists should be familiar with the appearance of neoplastic lesions by assessing loss of aceto-whitening and mucosal surface patterns.

Endoscopists should train in using the Japanese Esophageal Society (JES) classification to describe esophageal squamous cell lesions, to estimate the likelihood of and degree of dysplasia, and in the case of squamous cell cancer, the invasion depth.

Full Text

References

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