Magnifying image-enhanced endoscopy shows high diagnostic accuracy for invasion depth in superficial esophageal neoplasm

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European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology Published June 1, 2026 Medically reviewed June 1, 2026 Study authors: Jiang Wanting, Huang Yafang, Pang Jiale, Yang Simiao, Chen Runhua PubMed ↗ DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider the high diagnostic accuracy of magnifying image-enhanced endoscopy for staging superficial esophageal neoplasm.

This is a meta-analysis of twelve literatures evaluating the diagnostic accuracy of magnifying image-enhanced endoscopy for predicting invasion depth in superficial esophageal neoplasm. The primary synthesized finding is that for diagnosing carcinoma in situ or tumor infiltrating lamina propria mucosae, the pooled sensitivity was 0.88 (95%CI 0.83-0.92), specificity was 0.85 (95%CI 0.76-0.91), and the area under the curve was 0.93 (95%CI 0.91-0.95). For diagnosing tumor infiltrating muscularis mucosae or the upper third of the submucosal layer, sensitivity was 0.72 (95%CI 0.63-0.80) and specificity was 0.86 (95%CI 0.79-0.90). For deeper invasion, sensitivity was lower at 0.52 (95%CI 0.40-0.64) but specificity was very high at 0.99 (95%CI 0.98-0.99). The authors note that the setting and follow-up were not reported, and safety data were not available. The practice relevance is that this evidence can inform clinical treatment selection, though the findings are based on pooled diagnostic metrics rather than patient outcomes.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID42097052

View Original Abstract ↓

PURPOSE: The aim of this study was to assess the accuracy of magnifying image-enhanced endoscopy (IEE) for predicting the invasion depth of superficial esophageal neoplasm (SEN). METHODS: We searched PubMed, Embase, the Cochrane Library. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds radio (DOR) with 95% confidence interval (CI) were calculated by bivariate mixed effect model, the summary receiver operating characteristic (SROC) curve was drawn and the area under the curve (AUC) was calculated to comprehensively evaluate the diagnostic value of magnifying IEE for the invasion depth of SEN. RESULTS: Twelve literatures were included. The combined effect size of magnifying IEE in the diagnosis of carcinoma in situ (Tis) or tumor infiltrating lamina propria mucosae (LPM) were: sensitivity: 0.88(95%CI 0.83-0.92), specificity: 0.85(95%CI 0.76-0.91), PLR: 5.8(95%CI 3.6-9.3), NLR: 0.14(95%CI 0.09-0.20), DOR: 42 (95%CI 23-76), AUC: 0.93(95%CI 0.91-0.95); The combined effect size of magnifying IEE in the diagnosis of tumor infiltrating muscularis mucosae (MM) or tumor infiltrating the upper third of the submucosal layer (SM1) were: sensitivity: 0.72(95%CI 0.63-0.80), specificity: 0.86(95%CI 0.79-0.90), PLR: 5.0(95%CI 3.5-7.2), NLR: 0.32(95%CI 0.24-0.44), DOR: 15(95%CI 9-26), AUC: 0.86(95%CI 0.83-0.89); The combined effect size of magnifying IEE in the diagnosis of tumor infiltrating the middle third of the submucosal layer (SM2) or deeper were: sensitivity: 0.52(95%CI 0.40-0.64), specificity: 0.99(95%CI 0.98-0.99), PLR: 37.0(95%CI 24.5-55.9), NLR: 0.49(95%CI 0.38-0.63), DOR: 76(95%CI 45-127), AUC: 0.98(95%CI 0.96-0.99). CONCLUSION: Magnifying IEE shows good overall diagnostic performance for assessing the invasion depth of SEN, with excellent diagnostic efficacy for superficial lesions, while the diagnostic sensitivity for deep lesions is relatively low. It can provide helpful evidence for selecting appropriate clinical treatments.