Exploration of an effective training system for diagnosis of superficial esophageal squamous cell carcinoma with magnifying narrow‐band imaging: a prospective research

BACKGROUND AND AIMS The aim was to explore an effective training system for diagnosis of superficial esophageal squamous cell carcinoma (SESCC) and its staging with Magnifying narrow-band imaging (M-NBI). PATIENTS AND METHODS Fifteen endoscopists with no or less M-NBI experience participated in this training, which consisted of four stages and five teaching methods (M-NBI classification criterion, case analysis, hands-on operation, error correction and SESCC pathological knowledge). M-NBI images were evaluated and diagnostic accuracy was analyzed. RESULTS After training, the accuracy of distinguishing neoplastic esophageal from non-neoplastic (0.58±0.16 vs. 0.95±0.05, P=0.000) and diagnosing SESCC staging (0.25±0.26 vs. 0.89±0.08, P=0.000) with M-NBI were significantly increased. Participants with no M-NBI experience achieve equivalent diagnostic accuracy with less-experienced trainees after the training (0.91±0.08 vs. 0.92±0.04, P=0.816). Besides, diagnosis of MM (muscularis mucosa)/SM1 (submucosal) staging tumors (Stage I: 0.47±0.15 Stage II-III-IV: 0.76±0.12 ) with M-NBI was difficult for trainees and should be the focus of this training. Every teaching method could improve the diagnostic accuracy for esophageal lesions, especially for case analysis (from 0.59±0.10 to 0.85±0.08, P=0.000). In addition, the average operation score for trainees were significantly increased after hands-on teaching (60.40±11.11 vs. 91.80±4.28, P=0.0001). CONCLUSIONS For novices, this training system showed efficient performance for diagnosing SESCC staging with M-NBI. Diagnosing MM/SM1 staging SESCC was difficult for beginners, and should be the focus of training.