The factors influencing the accuracy of pre-operative endoscopic ultrasonography assessment in endoscopic treatments for gastrointestinal tumors.
The factors influencing the accuracy of pre-operative endoscopic ultrasonography assessment in endoscopic treatments for gastrointestinal tumors.
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消化道肿瘤内镜治疗术前超声内镜评估准确性影响因素
作者：
本研究旨在评价影响超声内窥镜(EUS)作为胃肠道肿瘤术前评估准确性的因素。共有261名患者264个胃肠道肿瘤被纳入研究。记录EUS检查胃肠道病变的参数，并与病理对照分析。EUS对粘膜内病变和上皮下病变的诊断准确率分别为83.6%和91.4%。194例(73.5%)病变起源于粘液层，术前超声检查证实。EUS预测胃、食道和结肠粘膜内病变T分期的准确率分别为77%、71.8%和84.6%。根据Paris内窥镜分类，EUS-病理符合组和不符合组的宏观模式分布不同(p=0.018)。在不符合组中，48.6%的糜烂性病变被分为0-IIc、0-IIa、 + IIc、0-IIc + IIa或0-III大体类型，而在符合组中这一比例为26%(p=0.025)。单因素分析显示，溃疡性病变(OR=7.516，95%可信区间[CI]2.574~21.952，p <； 0.001)、胃部位置(OR=3.619，95%CI 1.076~12.168，p=0.038)、恶性肿瘤(OR=2.920，95%CI 1.339~6.368，p=0.007)与超声检查的准确性显著相关。多因素Logistic回归分析显示，溃疡是影响EUS准确性的独立危险因素，其优势比为5.094(95%CI：1.641~15.807，P=0.005)。我们的研究结果表明，对于胃肠道肿瘤的合适的内窥镜治疗，EUS是一种可靠且易于使用的诊断工具。然而，在存在溃疡的情况下，EUS的诊断准确性似乎是值得怀疑的。浅表胃肠道肿瘤的术前分期是选择最合适的治疗方法的关键。我们的研究结果表明，超声内窥镜(EUS)是一种可靠且易于使用的诊断工具，可用于决策是否适合胃肠道肿瘤的内窥镜治疗。然而，在存在溃疡的情况下，EUS的诊断准确性似乎是值得怀疑的。
This retrospective study aimed to evaluate the factors influencing the accuracy of Endoscopic Ultrasonography (EUS) as a preoperative assessment for gastrointestinal tumors. A total of 261 patients with 264 gastrointestinal tumors were enrolled in the study. The parameters of the gastrointestinal lesions examined under EUS and their pathology were recorded and analyzed. The accuracy of EUS for detecting intramucosal lesions and subepithelial lesions (SELs) were 83.6% and 91.4%, respectively. One hundred and ninety‐four (73.5%) lesions originated from the mucous layer, as determined by pre‐operation EUS examinations. The accuracy of EUS in predicting the correct T stage for intramucosal lesions in the gastric region, esophagus, and colorectum was 77%, 71.8%, and 84.6%, respectively. According to the Paris endoscopic classification, the distribution of macroscopic patterns was different between the EUS‐pathology conformity and nonconformity groups (p = 0.018). In the nonconformity group, 48.6% of erosive lesions were classified as 0‐IIc, 0‐IIa + IIc, 0‐IIc + IIa or 0‐III macroscopic patterns compared with 26% patients in the conformity group (p = 0.025). Univariate analyses demonstrated that ulcerative lesions (OR = 7.516, 95% Confidence Interval [CI] 2.574–21.952, p < 0.001), location at the cardia of the stomach (OR = 3.619, 95%CI 1.076–12.168, p = 0.038), malignant tumor (OR = 2.920, 95%CI 1.339–6.368, p = 0.007) were significantly associated with EUS inaccuracy. Multivariate logistic regression analyses showed that ulcer was an independent risk factor associated with EUS inaccuracy, with odds ratios of 5.094 (95% CI: 1.641–15.807, p = 0.005). Our findings suggested that EUS is a reliable and easy‐to‐use diagnostic tool in decision‐making regarding appropriate endoscopic treatment for gastrointestinal tumors. However, the diagnostic accuracy of EUS appeared questionable in the presence of ulceration. Preoperative staging of superficial gastrointestinal tumors is crucial for choosing the most appropriate treatment. Our findings suggested that endoscopic ultrasonography (EUS) was a reliable and easy‐to‐use diagnostic tool in decision‐making regarding appropriate endoscopic treatment for gastrointestinal tumors. However, the diagnostic accuracy of EUS appeared questionable in the presence of ulceration.
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影响因子：
9.3
作者：
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影响因子：
5.3
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影响因子：
2.7
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Tomoda J
影响因子：
9.3
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7.7
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通讯作者：
CLASSEN, M