Korean J Gastrointest Endosc > Volume 33(5); 2006 > Article
Korean Journal of Gastrointestinal Endoscopy 2006;33(5): 263-270.
위암 환자에서 초음파내시경을 통한 병기 진단과 이에 영향을 미치는 인자
김보현·이동호*·강해연·고성준·양기영·이정훈·이광혁*·박영수*·황진혁*·김진욱*·정숙향*·김나영*·정현채·송인성
서울대학교 의과대학 내과학교실, 간 연구소, *분당서울대학교병원 내과
The Diagnostic Accuracy of Endoscopic Ultrasonography for the Preoperative Staging of Gastric Cancer: the Risk of Overstaging and Understaging
Bo Hyun Kim, M.D., Dong Ho Lee, M.D.*, Hae Yeon Kang, M.D., Seong Joon Koh, M.D., Ki Young Yang, M.D., Jeong Hoon Lee, M.D., Kwang Hyuck Lee, M.D.*, Young Soo Park, M.D.*, Jin-Hyeok Hwang, M.D.*, Jin-Wook Kim, M.D.*, Sook Hyang Jung, M.D.*, Nayoung Kim, M
Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, *Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Abstract

Background/Aims:
The preoperative staging of gastric cancer facilitates the planning of therapy. Preoperative endoscopic ultrasonography is a useful procedure for the staging of gastric cancer, but sometimes there can be problems with overstaging and understaging.
Methods:
Endoscopic ultrasonography was performed preoperatively on 171 patients with gastric cancer. The results of endoscopic ultrasonography were compared with the postoperative histological staging.
Results:
The overall accuracy of endoscopic ultrasonography for the determination of the T stage was 65.5%, the overall accuracy was 74.4%, 51.7% and 38.9% for determining the T1, T2 and T3 staging, respectively. Endoscopic ultrasonography had an accuracy of 67.3% for determining the absence of lymph node metastasis. In univariate analysis, the diagnostic accuracy was lower for infiltrative type and gastric cancer with microinvasion significantly. Multivariate analysis showed overstaging occurred for gastric cancers with concomitant ulcer, inflammation or submucosal fibrosis (p=0.004) and that understaging occurred for gastric cancers with infiltrative type or microinvasion (p=0.029, p<0.001).
Conclusions:
Endoscopic ultrasonography is a valuable diagnostic tool for most gastric cancers with some exceptions due to the overstaging and understaging. Gastric cancers with concomitant ulcer, inflammation or submucosal fibrosis may contribute to overstaging. By contrast, gastric cancers with infiltrative type or microinvasion may result in understaging. (Korean J Gastrointest Endosc 2006;33:263⁣270)
Key Words: Endoscopic ultrasonography, Gastric cancer
주요어: 초음파내시경 검사, 위암
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