Efficacy of Endoscopic Ultrasonography for Prediction of Tumor Depth in Gastric Cancer
Efficacy of Endoscopic Ultrasonography for Prediction of Tumor Depth in Gastric Cancer
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DOI：
10.5230/jgc.2011.11.2.109
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发表时间：
2011-06-01
影响因子：
2.5
通讯作者：
Han, Sang-Uk
中科院分区：
文献类型：
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作者：
Park, Ji Min;Ahn, Chang Wook;Han, Sang-Uk
目的：随着早期胃癌(EGC)所占比例的增加，微创治疗已成为EGC的主要治疗方法。准确的术前分期对确定治疗方案非常重要。为了解超声内窥镜检查(EUS)的准确性，我们将肿瘤的侵犯深度与术前EUS和术后病理结果进行比较。材料和方法：回顾分析152例腹腔镜胃切除术前行EUS检查的患者。结果：EUS与病理结果对肿瘤侵犯深度的符合率为41.4%。单因素分析显示，肿瘤直径>3 cm和肿瘤形态凹陷者，超声造影对肿瘤深度的预测准确率显著降低(P=0.033，P=0.035)。在多因素分析中，凹陷型(P=0.029，OR=2.873)和上腹部病变(P=0.035，OR=2.151)是影响腔内超声对肿瘤深度预测不准确的显著独立因素。结论：对于位于胃上1/3且形态凹陷的病变，在选择治疗方案时，应考虑与病理结果不符的可能性。
Purpose: As the proportion of early gastric cancer (EGC) has recently been increased, minimally invasive treatment is currently accepted as main therapy for EGC. Accurate preoperative staging is very important in determining treatment options. To know the accuracy of endoscopic ultrasonography (EUS), we compared the depth of invasion of the tumor with preoperative EUS and postoperative pathologic findings.Materials and Methods: We retrospectively analyzed 152 patients who underwent EUS before laparoscopic gastrectomy. The preoperative EUS results were compared with the pathological findings.Results: The overall proportion of coincidence for depth of invasion between EUS and pathologic results was 41.4%. Univariate analysis showed that the rate of corrected prediction of EUS for tumor depth significantly decreased for the lesions more than 3cm in diameter (P=0.033), and those with a depressed morphology (P=0.035). In multivariate analysis, the depressed type (P=0.029, OR=2.873) and upper lesion (P=0.035, OR=2.151) was the significantly independent factors influencing the inaccurate prediction of EUS for tumor depth.Conclusions: When we decide the treatment modality considering the clinical depth of invasion by EUS, the possibility of discordance with pathologic results should be considered for the lesions located in the upper third of the stomach and with a depressed morphology.