Objective To explore the diagnostic value of subtyping intrapapillary capillary loops (IPCLs) in esophageal lesions using blue laser imaging combined with magnifying endoscopy (BLI-ME) and its ability to predict the depth of infiltration in early esophageal carcinoma (EEC).

Methods The clinical data of 168 patients (174 lesions) with suspicious esophageal lesions were retrospectively analyzed to study the predictive role of IPCLs in determining the nature and depth of infiltration of esophageal lesions.

Results Among the lesions with type A IPCLs, 92.98% were diagnosed as esophagitis, while 97.44% of the lesions with type B IPCLs as EEC or precancerous lesions. The consistency between preoperative biopsy pathology and postoperative pathology was acceptable under BLI-ME (Kappa=0.573>0.4, P < 0.01). The accuracy of predicting the depth of infiltration of esophageal lesions based on B1, B2, and B3 subtypes of IPCLs was 89.86%, 61.90%, and 100.00%, respectively.

Conclusions The classification of mucosal IPCLs changes in suspected esophageal lesions under the observation of BLI-ME is helpful in determining the properties of the esophageal mucosa and the depth of lesion infiltration. Meanwhile, targeted biopsy under BLI-ME can achieve an accurate estimation of the lesions, so as to provide reference for treatment.