Department of Surgery, Ajou University, School of Medicine, Suwon, Korea.
J Gastric Cancer. 2011 Jun;11(2):109-15. doi: 10.5230/jgc.2011.11.2.109. Epub 2011 Jun 30.
As the proportion of early gastric cancer (EGC) has recently been increased, minimally invasive treatment is currently accepted as main therapy for EGC. Accurate preoperative staging is very important in determining treatment options. To know the accuracy of endoscopic ultrasonography (EUS), we compared the depth of invasion of the tumor with preoperative EUS and postoperative pathologic findings.
We retrospectively analyzed 152 patients who underwent EUS before laparoscopic gastrectomy. The preoperative EUS results were compared with the pathological findings.
The overall proportion of coincidence for depth of invasion between EUS and pathologic results was 41.4%. Univariate analysis showed that the rate of corrected prediction of EUS for tumor depth significantly decreased for the lesions more than 3cm in diameter (P=0.033), and those with a depressed morphology (P=0.035). In multivariate analysis, the depressed type (P=0.029, OR=2.873) and upper lesion (P=0.035, OR=2.151) was the significantly independent factors influencing the inaccurate prediction of EUS for tumor depth.
When we decide the treatment modality considering the clinical depth of invasion by EUS, the possibility of discordance with pathologic results should be considered for the lesions located in the upper third of the stomach and with a depressed morphology.
由于早期胃癌（EGC）的比例最近有所增加，微创治疗目前被认为是 EGC 的主要治疗方法。准确的术前分期对于确定治疗方案非常重要。为了了解内镜超声（EUS）的准确性，我们比较了肿瘤的浸润深度与术前 EUS 和术后病理发现。
我们回顾性分析了 152 例在腹腔镜胃切除术前接受 EUS 的患者。将术前 EUS 结果与病理结果进行比较。
EUS 与病理结果对浸润深度的总体符合率为 41.4%。单因素分析显示，对于直径大于 3cm 的病变（P=0.033）和凹陷型病变（P=0.035），EUS 对肿瘤深度的校正预测率显著降低。多因素分析显示，凹陷型（P=0.029，OR=2.873）和上消化道病变（P=0.035，OR=2.151）是影响 EUS 对肿瘤深度预测不准确的独立因素。
当我们根据 EUS 评估的临床浸润深度来决定治疗方式时，对于位于胃上部且形态凹陷的病变，应考虑与病理结果不一致的可能性。
