Department of Gastroenterology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
J Zhejiang Univ Sci B. 2013 Sep;14(9):844-8. doi: 10.1631/jzus.B1200307.
The objective of this study was to investigate the endosonographic appearance of gastric linitis plastica (GLP) and to study the usefulness of endoscopic ultrasonography (EUS) for the T and N staging of GLP. EUS examinations of 55 patients with histologically proven GLP were retrospectively studied. In all patients, EUS showed that lesions involved at least one-third of the circumference of the stomach. Based on the findings of the EUS, the 55 patients were divided into two groups. There were 32 (58.2%) patients in the first group. EUS of this group showed that the five sonographic layers had disappeared and had been replaced by a hypoechogenic thickening of the gastric wall. There were 23 (41.8%) patients in the second group. EUS of this group showed that the first three sonographic layers were blurred and thickened, and the fourth layer was significantly thickened. The full thickness of the gastric wall was significantly thicker in first than in the second group of patients (P<0.01). The incidence of perigastric lesions was significantly higher in the first than in the second group of patients (P<0.01). Results for the 15 patients following preoperative EUS were compared postoperatively with histopathologic findings for T and N staging. The overall diagnostic accuracy of the T stage was 73.3% and of the N stage was 60.0%. In eight patients, we used EUS to assess a therapeutic response. No response was observed in five patients and a partial response in three. EUS images of GLP are characteristic. EUS is helpful in diagnosing GLP and for assessing the T and N stages.
本研究旨在探讨胃弥漫浸润型胃癌（GLP）的内镜超声（EUS）表现，并研究 EUS 对 GLP 的 T 和 N 分期的作用。回顾性研究了 55 例经组织学证实的 GLP 患者的 EUS 检查结果。所有患者的 EUS 检查均显示病变至少累及胃周的三分之一。根据 EUS 的检查结果，将 55 例患者分为两组。第一组有 32 例（58.2%）患者。EUS 显示这组患者的 5 个超声层消失，被胃壁低回声增厚所取代。第二组有 23 例（41.8%）患者。EUS 显示这组患者的前 3 个超声层模糊增厚，第 4 层明显增厚。与第二组相比，第一组患者胃壁的全层厚度明显增厚（P<0.01）。第一组患者的胃周病变发生率明显高于第二组（P<0.01）。对 15 例术前 EUS 患者的结果与术后组织病理学 T 和 N 分期结果进行比较。T 分期的总体诊断准确率为 73.3%，N 分期的诊断准确率为 60.0%。在 8 例患者中，我们使用 EUS 评估治疗反应。5 例患者未见反应，3 例患者部分反应。GLP 的 EUS 图像具有特征性。EUS 有助于诊断 GLP，并有助于评估 T 分期和 N 分期。
