The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound.
The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound.
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新美国癌症联合委员会胃部 T 分期系统：复杂性增加，但超声内镜预测准确性没有明显改善
DOI：
10.1186/s12876-020-01558-8
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发表时间：
2021-06-11
影响因子：
2.4
通讯作者：
Hou X
中科院分区：
文献类型：
--
作者：
Han C;Xu T;Zhang Q;Liu J;Ding Z;Hou X
BackgroundThe efficacy of endoscopic ultrasound (EUS) for determining the T category of gastric cancer is variable. The aim of this study was to evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition.MethodsA retrospective analysis of clinical and EUS imaging features of 348 gastric carcinoma patients who underwent radical resection were retrospectively analyzed. Differences between the 6th and 7th/8th edition T staging systems for preoperative EUS evaluation were compared.ResultsThe accuracy of EUS T staging was 72.4% for the 7th/8th edition and 78.4% for the 6th edition. T3 stage accuracy was significantly worse when the T3 group status was changed. The tumor location, echoendoscope type, and histological type were associated with inaccuracy. We further analyzed the EUS image features for each tumor T stage and found that an indistinctly visible muscularis propria (MP) or with obvious thickening was considered an indicator of lesions involved in the MP with a sensitivity of 81.3%; an MP completely disappeared and accompanied with a serosal layer intact may be a marker that the lesion invaded to the subserosa. We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%.ConclusionsThe increased complexity of the 7th/8th edition T staging system is accompanied by worsening of the predictive accuracy for EUS as compared to the 6th edition. Furthermore, the tumor location, echoendoscope type, histological type, and EUS image features for each tumor T stage should warrant attention.
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影响因子：
1.6
作者：
Han C;Lin R;Shi H;Liu J;Qian W;Ding Z;Hou X
通讯作者：
Hou X
影响因子：
4.3
作者：
Wu, Chen-Xi;Zhu, Zhao-Hui
通讯作者：
Zhu, Zhao-Hui
影响因子：
5.2
作者：
Bando, E;Kawamura, T;Yonemura, Y
通讯作者：
Yonemura, Y
影响因子：
3.3
作者：
Sitarz R;Skierucha M;Mielko J;Offerhaus GJA;Maciejewski R;Polkowski WP
通讯作者：
Polkowski WP
影响因子：
7.4
作者：
He, Xingkang;Wu, Wenrui;Sun, Lei-min
通讯作者：
Sun, Lei-min