Objective:

To compare the diagnostic efficacy of white light endoscopic (WLE), narrow band imaging (NBI), and iodine staining, both individually and in combination, for the detection of early esophageal cancer (EC) and precancerous lesions.

Approach:

• Study Design: A retrospective analysis was conducted on 55 patients with suspected early EC or precancerous lesions who underwent simultaneous endoscopic examination using WLE, NBI, and iodine staining.
• Data Collection: A total of 63 lesions were identified, and surgical histopathological results or follow-up confirmation served as the gold standard for diagnostic performance evaluation.

Key Findings:

• Among the 63 suspected lesions, 5 cases of early EC and 37 cases of precancerous lesions were confirmed by histopathology or follow-up.
• The combined diagnostic approach with iodine staining showed significantly higher accuracy and sensitivity for early EC compared to WLI or NBI alone (P < 0.05).
• Agreement with pathological findings was poor for WLI (Kappa = 0.327), fair for NBI (Kappa = 0.476), fair for iodine staining (Kappa = 0.577), and substantial for the combined method (Kappa = 0.715).
• The false positive rate for mucosal staining was lower than that for background coloration.

Interpretation:

Limitations:

• The study is retrospective and conducted at a single institution.
• The sample size is relatively small with only 55 patients.

Conclusion: