Integrated diagnostic strategy for the invasion depth of early gastric cancer by conventional endoscopy and EUS - 13/08/15
Abstract |
Background |
Although conventional endoscopy (CE) and EUS are considered useful for predicting the invasion depth (T-staging) in early gastric cancer (EGC), no effective diagnostic strategy has been established.
Objective |
To produce simple CE criteria and to elucidate an efficient diagnostic method by combining CE and EUS for accurate T-staging.
Design |
Single-center retrospective analysis.
Setting |
Academic university hospital.
Patients |
Consecutive patients with EGC from April 2007 to March 2012 who underwent CE and EUS before treatment.
Interventions |
Recorded endoscopic images were independently reviewed by 3 observers. The CE criteria for massive invasion were defined, and their utility and the additional value of EUS were assessed.
Main Outcome Measurements |
The accuracy of CE based on the criteria and the accuracy of EUS.
Results |
Two hundred thirty patients were enrolled: 195 with mucosal cancer or cancer in the submucosa less than 500 μm from the muscularis mucosae and 35 with invasive cancers. Multivariate analysis of the CE findings by 1 observer revealed that an irregular surface and a submucosal tumor–like marginal elevation were significantly associated with massive invasion. The simple CE criteria, consisting of those 2 features, had an overall accuracy of 73% to 82% and no significant differences in the diagnostic yield compared with EUS in all observers. CE accurately revealed mucosal cancer, and EUS efficiently salvaged the lesions that were over-diagnosed by CE. With our strategy, which involved the CE criteria and the optimal use of EUS, the comprehensive accuracy exceeded 85% in each observer.
Limitations |
Retrospective, single-center study.
Conclusions |
We demonstrated a practical strategy for T-staging in EGC using simple CE criteria and EUS.
Le texte complet de cet article est disponible en PDF.Abbreviations : CE, EGC, ESD, M, SM1, SM-M, MP, SMT
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
Vol 82 - N° 3
P. 452-459 - septembre 2015 Retour au numéro
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