Accuracy of high-frequency catheter-based endoscopic ultrasonography according to the indications for endoscopic treatment of early gastric cancer
Accuracy of high-frequency catheter-based endoscopic ultrasonography according to the indications for endoscopic treatment of early gastric cancer
复制标题
DOI：
10.1111/j.1440-1746.2009.06111.x
复制
发表时间：
2010-03-01
影响因子：
4.1
通讯作者：
Song, Geun Am
中科院分区：
文献类型：
--
作者：
Kim, Gwang Ha;Park, Do Youn;Song, Geun Am
背景和目的：内镜治疗的发展，如内镜粘膜下剥离术，扩大了早期胃癌（EGC）患者内镜切除术的适应证。超声内镜是判断胃癌浸润深度的首选影像学检查方法。本研究的目的是前瞻性地评估EUS确定EGC的深度的准确性，根据接受/扩展indications.Methods：我们前瞻性地包括了178例患者共181个病变，EGC的内镜诊断，谁接受EUS分期肿瘤浸润深度使用20 MHz的导管探头。我们调查的准确性，EUS确定的深度内镜怀疑EGC，然后分析的差异，EUS的准确性，根据接受/扩展indications.Results：在178例患者中，5例患者下降，因为没有最终的组织学结果。在173例患者的176个病灶中，EUS评估肿瘤浸润深度的准确性为80.7%（142/176个病灶）。EUS对具有公认适应症和扩展适应症的病变的准确性分别为97.6%（40/41个病变）和83.6%（46/57个病变）（P = 0.040）。在扩大适应证的病变中，EUS诊断准确率下降，尤其是溃疡性病变和微小黏膜下浸润病变（分别为79.2%和42.9%），结论：扩大适应证的病变EUS诊断准确率低于公认适应证。特别是，在内镜治疗前，应仔细考虑溃疡和微小粘膜下浸润的病变，通过治疗前EUS分期。
Background and Aim:The development of endoscopic treatment, such as endoscopic submucosal dissection, extends the indications for endoscopic resection in patients with early gastric cancer (EGC). Endoscopic ultrasonography (EUS) is the first-choice imaging modality for determining the depth of invasion of gastric cancer. The aim of the present study was to prospectively assess the accuracy of EUS for determining the depth of EGC, according to the accepted/extended indications.Methods:We prospectively included a total of 181 lesions in 178 patients, with an endoscopic diagnosis of EGC, who underwent EUS for staging the depth of tumor invasion using a 20-MHz catheter probe. We investigated the accuracy of EUS for determining the depth of endoscopically-suspected EGC and then analyzed the difference in the accuracy of EUS according to the accepted/extended indications.Results:Of the 178 patients, five patients were dropped because of the absence of final histological results. For the 176 lesions in 173 patients, the accuracy of EUS assessment for the depth of tumor invasion was 80.7% (142 of 176 lesions). The accuracy of EUS for the lesions with accepted indications and with extended indications was 97.6% (40 of 41 lesions) and 83.6% (46 of 57 lesions), respectively (P = 0.040). Of the lesions with extended indications, the accuracy of EUS decreased especially for the lesions with ulceration and those with minute submucosal invasion (79.2% and 42.9%, respectively).Conclusions:The accuracy of EUS for the lesions with the extended indications was lower than that for the lesions with the accepted indications. In particular, lesions with ulceration and minute submucosal invasion should be carefully considered prior to endoscopic treatment by pretreatment EUS staging.