Examination of Endoscopic Ultrasonographic Diagnosis for the Depth of Early Gastric Cancer
| Autor: | Hidekazu Kitakata, Masashi Okuro, Taishi Ishisaka, Ken Kawaura, Shigeto Morimoto, Yuta Igarashi, Toshihiro Higashikawa, Kumie Kodera, Sadahumi Azukisawa, Tazuo Okuno, Rika Kobayasi, Hiroaki Kuno, Tohru Itoh, Hiroshi Yano, Kunimitsu Iwai, Junji Kamai, Kazu Hamada, Osamu Iritani, Takuro Morita, Taroh Himeno |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Invasion depth
medicine.medical_specialty Muscularis mucosae Endoscopic ultrasonography 03 medical and health sciences 0302 clinical medicine Histological diagnosis Submucosa medicine Early gastric cancer medicine.diagnostic_test business.industry Depth Endoscopy General Medicine Endoscopic submucosal dissection digestive system diseases Early Gastric Cancer medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Original Article Radiology business |
| Zdroj: | Journal of Clinical Medicine Research |
| ISSN: | 1918-3011 1918-3003 |
| Popis: | Background: Endoscopic ultrasonography (EUS) is one of the helpful tools to diagnose depth of early gastric cancer (EGC). In this study, we examined efficiencies of EUS for EGC such as overall accuracy, risk factors of over/under-staging, and accuracies of each invasive distance. Methods: A total of 403 EGC lesions that could be investigated by EUS during pre-operation and histological diagnosis after endoscopic submucosal dissection (ESD) or surgery were enrolled in this study. For the 403 cases, we analyzed the accuracies of depth by conventional endoscopy (CE) and EUS retrospectively. We evaluated the clinical survey items of CE and EUS which will be described later to compare the differences between “accuracy group” and “over-staging group”, and between “accuracy group” and “under-staging group”, retrospectively. Additionally, 78 EGC lesions which were confined to the submucosa and for which it was possible to measure accurate invasive distance from the muscularis mucosae were examined for the relationship between preoperative diagnosis of depth by CE and EUS and invasive distance retrospectively. Results: The overall accuracies of both CE and EUS in predicting EGC invasion depth were 87.3%. For CE staging, histological classification was the factor which influenced over-staging. Gastric regions and tumor area were the factors which influenced under-staging of CE. For EUS staging, tumor area was the factor which influenced over-staging, and gastric regions were the factors which influenced under-staging. Both CE and EUS were not sufficient for predicting the lesions confined to < 500 µm from the muscularis mucosae because the accuracies of both in predicting depth were less than 50%. However, EUS has a higher accuracy than CE for the lesions confined to 500 - 2,000 µm. Conclusions: The overall accuracies of both CE and EUS in predicting EGC invasion depth were equal, but the contributing factors for over/under-staging were different. Both CE and EUS are not sufficient at present to predict the lesions confined to < 500 µm from the muscularis mucosae. However, the accuracy of EUS in predicting them may increase if high-performance EUS systems are developed in the future. J Clin Med Res. 2021;13(4):222-229 doi: https://doi.org/10.14740/jocmr4465 |
| Databáze: | OpenAIRE |
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