Usefulness of Endoscopic Ultrasonography in Determining the Depth of Invasion and Indication for Endoscopic Treatment of Early Gastric Cancer
Journal of Clinical Gastroenterology Volume 43 Issue 4
Page 318-322
published_at 2009
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Title ( eng ) |
Usefulness of Endoscopic Ultrasonography in Determining the Depth of Invasion and Indication for Endoscopic Treatment of Early Gastric Cancer
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Creator |
Mouri Ritsuo
Oka Shiro
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Source Title |
Journal of Clinical Gastroenterology
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Volume | 43 |
Issue | 4 |
Start Page | 318 |
End Page | 322 |
Abstract |
Introduction: Endoscopic ultrasonography (EUS) is a useful method for visualizing features of gastric cancer. However, a previously reported classification system tended to result in overstaging. We investigated the usefulness of EUS for evaluation of the depth of gastric cancer invasion and indications for endoscopic treatment. Methods: Accuracy of EUS for determining the depth of invasion and incidences of a positive basal margin were assessed in 235 patients who underwent endoscopic treatment or surgery for gastric cancer. The EUS-determined depth of invasion was classified its follows: EUS-M (lesion confined to sonographic layers 1 and 2); EUS-M/SM border (lesion with changes in sonographic layer 3 but no deeper than 1 min); EUS-SM (lesion with changes in sonographic layer 3 deeper than 1 mm); or EUS-AD (lesion with changes in sonographic layer 4 or 5). Results: Accuracy of EUS for determining the depth of invasion was as follows: EUS-M, 99% were M and SM1 lesions; EUS-M/SM border, 87% were M and SM1 lesions; EUS-SM, 91% were SM2 lesions; EUS-AD, 100% were muscularis propria or deeper lesions. There was no EUS-M or EUS-M/SM border lesion for which endoscopic treatment resulted in it positive basal margin. Conclusions: EUS is useful for accurately determining the depth of invasion of gastric cancer. When there are no endoscopically determined ulcerous changes. endoscopic treatment should be considered for EUS-M and EUS-M/SM border lesions, and EUS-SM lesions should be treated surgically.
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Keywords |
early gastric cancer. endoscopic ultrasound. endoscopic treatment
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NDC |
Medical sciences [ 490 ]
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Language |
eng
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Resource Type | journal article |
Publisher |
Lippincott Wolliams & Wilkins
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Date of Issued | 2009 |
Publish Type | Author’s Original |
Access Rights | open access |
Source Identifier |
[ISSN] 0192-0790
[DOI] 10.1097/MCG.0b013e3181775966
[NCID] AA00257261
[DOI] http://dx.doi.org/10.1097/MCG.0b013e3181775966
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