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Accuracy of endoscopic ultrasonography for diagnosing the depth of early gastric cancer with or without ulcer fibrosis



Accuracy of endoscopic ultrasonography for diagnosing the depth of early gastric cancer with or without ulcer fibrosis



Stomach & Intestine (Tokyo) 37(9): 1095-1103



In this paper, we reported the accuracy of endoscopic ultrasonography (EUS) for diagnosing the cancer depth of gastric cancer, especially early gastric cancer with or without ulcer fibrosis. The accuracy of EUS is 91.5% in mucosal cancer, 68.7% in submucosal cancer, 64.9% in muscularis propria cancer, 74.6% in subserosal cancer, 83.5% in serosal cancer, 61.3% in si (T4) cancer, and totally 79.6% (1,496/1,880). The echo level of ulcer fibrosis is similar to that of cancer, so fibrosis causes wrong diagnosis in gastric cancer with ulcer fibrosis. We proposed pattern analysis for differentiating fibrosis from cancer invasion. Our pattern analysis is based on the fact that, histologically, ulcer fibrosis always has fan-shaped spreading and cancer has arch-shaped spreading. However even if we employed this pattern analysis, microinvasion to the submucosa can't be detected by EUS. Therefore, compared to the others, the diagnostic accuracy of EUS in early cancer with ulcer is relatively low. However, now, we have three dimensional EUS (3D-EUS) which carries out multiple radial scanning and a linear scan at the same time. Using 3D-EUS, we will be able to detect 500mum invasion to the submucosa in the near future.

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Accession: 010115829

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