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World J Gastroenterol. Apr 14, 2021; 27(14): 1392-1405
Published online Apr 14, 2021. doi: 10.3748/wjg.v27.i14.1392
Artificial intelligence-assisted endoscopic detection of esophageal neoplasia in early stage: The next step?
Yong Liu
Yong Liu, Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430011, Hubei Province, China
Author contributions: Liu Y designed the paper, collected and analyzed the data in the references, and wrote the manuscript; the author has read and approved the final manuscript.
Conflict-of-interest statement: The author has nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Liu, MD, PhD, Surgeon, Surgical Oncologist, Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Wuhan 430011, Hubei Province, China. liuyong7575@163.com
Received: January 10, 2021
Peer-review started: January 10, 2021
First decision: February 11, 2021
Revised: February 23, 2021
Accepted: March 13, 2021
Article in press: March 13, 2021
Published online: April 14, 2021
Abstract

Esophageal cancer (EC) is a common malignant tumor of the digestive tract and originates from the epithelium of the esophageal mucosa. It has been confirmed that early EC lesions can be cured by endoscopic therapy, and the curative effect is equivalent to that of surgical operation. Upper gastrointestinal endoscopy is still the gold standard for EC diagnosis. The accuracy of endoscopic examination results largely depends on the professional level of the examiner. Artificial intelligence (AI) has been applied in the screening of early EC and has shown advantages; notably, it is more accurate than less-experienced endoscopists. This paper reviews the application of AI in the field of endoscopic detection of early EC, including squamous cell carcinoma and adenocarcinoma, and describes the relevant progress. Although up to now most of the studies evaluating the clinical application of AI in early EC endoscopic detection are focused on still images, AI-assisted real-time detection based on live-stream video may be the next step.

Keywords: Early esophageal cancer, Artificial intelligence, Endoscopy, Diagnosis, Trend

Core Tip: Esophageal cancer (EC) is one of the most common malignant tumors of the digestive tract. Early EC lesions can be cured by endoscopic therapy, and the curative effect is equivalent to that of surgical operation. Upper gastrointestinal endoscopy is still the gold standard for EC diagnosis, while the accuracy of endoscopy depends in part on professional experience. Artificial intelligence applied in the screening of early EC has been shown to be a good assistant for those less-experienced endoscopists. This manuscript reviews the state of the art of artificial intelligence applications in clinical early EC detection by endoscopy for those who will be interested in this field.