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Background Superficial esophageal squamous cell carcinoma (SESCC),defined as ESCC limited to the mucosa or submucosa,thus has better prognosis and higher cure rate compared to advanced carcinoma.The Inoues,Arimas and Japan Esophageal Society(JES) IPCL classifications have been proposed to estimate the invasion depth of SESCC during the past two decades,and been widely used by Japanese endoscopists.Among them,JES classification was thought to be superior to the other two.However,diagnostic performance of the three classifications on Chinese patients have not yet been evaluated.Aims To compare the diagnosis characteristics of the three IPCL classifications on SESCC.Methods Magnified endoscopic narrow band images of 62 SESCC lesions from 62 patients were interpreted by two endoscopists,who independently determined the IPCL pattern of each lesion according to the three classifications respectively.These readings were compared with the histopathological findings by endoscopic resection.Overall agreement rate,interobserver concordance,diagnostic sensitivity of JES classification for each invasion layer and the diagnostic capacity for lesions invading to muscularis mucosa and deeper were reported.Results The overall agreement rate of each IPCL classification compared with histopathology was 71.8 ± 8.0% (Inoues classification),75.8 ± 11.5% (Arimas classification),and 59.7±9.1% (Japan Esophageal Society classification) respectively.The interobserver agreement (kappa values) between the two endoscopists was 0.445,0.412,and 0.064 respectively.The sensitivity of JES classification for each layer varied between the two endoscopists within each layer,reflecting poor interobserver agreement.The sensitivity for lesions that invade to muscularis mucosa and deeper was 85.7% vs.28.6% (Inoues classification),57.1% vs.42.9% (Arimas classification),and 85.7% vs.14.3% (JES classification),by the two endoscopists,while the specificity was 94.5% vs.96.4%,100% vs.100%,and 100% vs.94.5%,respectively.Conclusion: JES classification exhibits fair agreement rate,sensitivity and specificity but unsatisfying interobserver agreement following a short period of studying,compared with the other two classifications.