Endoscopic ultrasonography, Early gastric cancer, Staging, Mucosal cancer, Submucosal cancer"/> The Usefulness of Endoscopic Ultrasonoraphy for Discriminating Gastric Mucosal Cancer from Submucosal Invasion
Korean J Gastrointest Endosc > Volume 34(5); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;34(5): 244-250.
점막암과 점막하층암 감별에서 내시경 초음파검사의 유용성
이승현·장용석·전상훈·김성열·장병국·정우진·조광범·박경식·황재석
계명대학교 의과대학 내과학교실
The Usefulness of Endoscopic Ultrasonoraphy for Discriminating Gastric Mucosal Cancer from Submucosal Invasion
Seung Hyun Lee, M.D., Yong Seok Jang, M.D., Sang Hoon Jeon, M.D., Seong Yeol Kim, M.D., Byoung Kuk Jang, M.D., Woo Jin Chung, M.D., Kwang Bum Cho, M.D., Kyung Sik Park, M.D. and Jae Seok Hwang, M.D.
Department of Internal medicine, Keimyung University School of Medicine, Daegu, Korea
Abstract

Background/Aims:
Endoscopic ultrasonography (EUS) has been used to discriminate gastric mucosal cancer (T1m) from submucosal invasion (T1sm). Thus the aims of this study are 1) to determine the accuracy of EUS for diagnosing tumor depth, 2) to compare the accuracy of EUS with the endoscopic impressions of variously experienced endoscopists and 3) to compare the accuracy of performing EUS by one doctor according to the experience.
Methods:
The EUS and pathologic reports of early gastric cancer patients were analyzed. The same endoscopic images were reviewed again by 3 endoscopists, who had one-, three- and five-years experience, respectively. The accuracies of EUS and conventional endoscopy were analyzed.
Results:
77 patients were included from November 2003 to October 2005. The κ of the EUS for actual examiner and conventional endoscopy for reviewer 1, reviewer 2 and reviewer 3 were 0.421, 0.134, 0.359 and 0.307, respectively and accuracies were 68.8%, 45.5%, 67.5% and 62.3%, respectively. Of the 52 T1m patients, 23 (44.2%) were overstaged as T1sm with performing EUS. But of 25 T1sm patients, only 1 (4.0%) was understaged as T1m with performing EUS. The accuracy and κ of the EUS for one doctor during the first-year experience were 60.6% and 0.316, respectively, and they were 75.0% and 0.508, respectively during the second-year experience.
Conclusions:
EUS is useful for complementing the conventional endoscopic discrimination of gastric mucosal cancer from submucosal invasion. Yet physician should keep in mind the relatively common overstaging. (Korean J Gastrointest Endosc 2007;34:244⁣250)
Key Words: Endoscopic ultrasonography, Early gastric cancer, Staging, Mucosal cancer, Submucosal cancer
주요어: 내시경초음파검사, 조기위암, 암병기, 점막암, 점막하층암
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