Korean J Gastrointest Endosc.  2001 Dec;23(6):437-444.

The Usefulness of Endoscopic Ultrasonography and Endoscopy in Diagnosing Depth of Invasion of Early Gastric Cancer for the Selection of Proper Candidates for Endoscopic Mucosal Resection

• Park SY
• Lee KJ
• Cha CK
• Kim JH
• Hahm KB
• Cho SW

Abstract

BACKGROUND/AIMS: If a cancer lesion without ulcer can be correctly staged as mucosal, it can be a candidate for curative endoscopic treatment such as endoscopic mucosal resection. The aim of this study was to evaluate the usefulness of EUS and endoscopy in diagnosing mucosal cancer of stomach.
METHODS
Findings of endoscopy and EUS were independently reviewed by the conventional criteria for diagnosing depth of invasion and compared with histologic findings in 65 patients having EGC without ulcers.
RESULTS
Overall accuracy of diagnosing depth of invasion were 69% by endoscopy and 78% by EUS. The accuracy rates according to the macroscopic type by endoscopy were 86% (12/14) for type I, 75% (3/4) for type IIa, 75% (9/12) for type IIa+IIc, 50% (2/4) for type IIc+IIa, 66% (19/29) for type IIc and 0% (0/2) for type IIc+IIb. The accuracy rates according to the macroscopic type by EUS were 93% (13/ 14) for type I, 50% (2/4) for type IIa, 75% (9/12) for type IIa+IIc, 50% (2/4) for type IIc+IIa, 83% (24/29) for type IIc and 50% (1/2) for type IIc+IIb. All lesions that were classified as limited to the mucosa on both conventional endoscopy and EUS in type I (n=9), IIa (n=2), IIa+IIc (n=2) and IIc (n=11) were limited to the mucosa by histologic findings.
CONCLUSIONS
This study suggests that if both modalities show the findings of mucosal lesion in type I and IIc of EGC, endoscopic mucosal resection may be considered as a curative treatment.

Keyword

Early gastric cancer; Depth of invasion

MeSH Terms

Endoscopy*
Endosonography*
Humans
Mucous Membrane
Stomach Neoplasms*
Ulcer