Comparison of Diagnostic Accuracy between Endoscopy and EUS for Depth of Invasion in Early Gastric Cancer

Kim, Jin Oh; Hong, Su Jin; Cho, Young Deok; Bong, Hyung Keun; Cho, Joo Young; Kim, Yun Soo; Lee, Joon Seong; Lee, Moon Sung; Hwang, Seong Gyu; Shim, Chan Sup

Abstract

BACKGROUND/AIMS: The purpose of this study was to cornpare diagnostic accuracy between endoscopy and endoscopic ultrasonography for depth of invasion in early gastric cancer according to types of endoscopic findings.
METHODS
Sixty-three patients with early gastric cancer were pre-operatively examined by endoscopy and endoscopic ultrasonography(EUS). Then, the depth of invasion in early gastric cancer by endoscopy and EUS were compared with pathological findings of resection specimens.
RESULTS
Types of endoscopic findings of early gastric cancer(EGC) were type I in 7 cases, type IIa in 2 cases, type IIa+IIc in 5 cases, type IIb in I case, type IIc in 28 cases, type IIc+1II in 11 cases, type III in 2 cases, type III+IIc in 2 cases, EGC-like advanced gastric cancer in 4 cases, advanced gastric cancer in 1 case. Concerning the depth of invasion, 23 cases were mucosal cancer and 40 cases were submucosal cancer in pathologic diagnosis of resected specimens. The diagnostic accuracy rate of endoscopy for depth of invasion in EGC was 78.3%(18/23) in mucosal cancer, 65%(26/40) in submucosal cancer and overall accurcy was 69.8%. The diagnostic accuracy rate of endoscopic ultrasonography for depth of invasion in EGC was 73.9%(17/23) in mucosal cancer, 80.0%(32/40) in submucosal cancer and overall accurcy was 77.8%.
CONCLUSIONS
EUS was found to be more accurate than endoscopy in assessing the depth of invasion in early gastric cancer according to types of endoscopic findings and was especially useful for the improving of the diagnostic accuracy in assessing the depth of invasion in early gastric cancer, preoperatively.