Diagnostic value of endoscopic ultrasonography for staging of early gastric cancer
10.3760/cma.j.issn.1007-5232.2017.09.011
- VernacularTitle:内镜超声检查在早期胃癌分期中的应用价值及影响因素分析
- Author:
Weixiao HU
1
;
Shunhua LONG
;
Qiang WANG
;
Xu SHU
;
Yin ZHU
;
Zhendong ZHANG
;
Xuan ZHU
;
Nonghua LYU
;
Youxiang CHEN
Author Information
1. 南昌大学第一附属医院消化内科
- Keywords:
Endoscopic ultrasonography;
Early gastric cancer;
Neoplasm stage;
Risk factors
- From:
Chinese Journal of Digestive Endoscopy
2017;34(9):662-666
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the diagnostic value of endoscopic ultrasonography(EUS)for staging of early gastric cancer(EGC)and its influential factors. Methods Clinical information of 120 EGC patients admitted from February 2009 to January 2016 was reviewed. Diagnostic accuracy and the influencing factors of EUS for the invasive depth were analyzed by comparing the results of preoperative EUS and the pathology. Results Thirty-six patients were over-staged by EUS,and 10 patients were under-staged among 120 EGC patients. The accuracy, sensitivity, specificity of EUS for the submucosal invasion were 61.67%(74/120),58.33%(14/24),62.50%(60/96)respectively. The accuracy, sensitivity and specificity for protruded EGCs(Type I)diagnosis were 74.36%(29/39), 50.00%(6/12), 85.19%(23/27) respectively;these three variables were 59.02%(36/61),83.33%(5/6),56.36%(31/55)respectively for flat EGCs(Type Ⅱ), and 45.00%(9/20), 50.00%(3/6), 42.86%(6/14)respectively for excavated EGCs(Type Ⅲ). The univariate factor results showed that differentiated degree, location and endoscopic morphology of the tumor were possible influential factors for over-stage. Multivariate factor results showed that flat type(OR=3.667,95%CI:1.086-12.386,P<0.05)and excavated type(OR=6.552,95%CI:1.421-30.218,P<0.05)were independent risk factors. Gender,age and tumor maximum diameter were not factors influencing the diagnostic accuracy of EUS. Conclusion The EUS shows higher clinical value for diagnosing the invasive depth in EGC. Tumor differentiated degree, location and endoscopic morphology may be the influencing factors for diagnostic accuracy of EUS. Flat type and excavated type may lead to over-staging.
