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New Endoscopic Diagnosis and Treatment Options for Early Esophageal Cancer

Quan-Lin Li, Yun-Shi Zhong, Wei-Feng Chen, Meng-Jiang He, Ping-Hong Zhou and Li-Qing Yao

Recent advances in endoscopic technology have increased detection rates of early esophageal cancer. Novel imaging techniques, such as narrow band imaging, autofluorescence imaging, confocal laser endomicroscopy and optical coherence tomography, have been recently introduced that may be taking us closer to the “optical biopsy” for dignosis of esophageal lesions. Along with the increased endoscopic detection rates, more and more early esophageal lesions have been also treated by endoscopic options. There are now long-term randomized controlled data concerning the effectiveness of ablative approaches (photodynamic therapy, cryotherapy and radiofrequency ablation); however, the ablation does not provide a tissue specimen for histopathological assessment. Unlike ablative techniques, endoscopic resection permits histopathological assessment, similar to surgery. As a new resection technique, endoscopic submucosal dissection results in complete eradication of all diseases and may translate to a lower recurrence rate than conventional endoscopic mucosal resection procedure.