Esophagus, Stomach & Intestine; Evaluation of Endoscopic Ultrasonography in Gastric Carcinoma

Park, Hong Bae; Yeo, Hyang Soon; Kang, Myung Weon; Oh, Ki Chang; Cho, Jang Hyun; Cho, Hyung Chul; Chu, Jin Ho; Kim, Weon Seuk; Kim, Myung Won

Abstract

BACKGROUND
Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma.
METHODS
In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging.
RESULTS
1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4.
CONCLUSIONS
EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.