Clinical Gastroenterology Vol.16 No.12(2-2)

Theme Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer
Title Evaluation of the Depth of Invasion of Early Gastric Cancers by Endoscopic Ultrasonography for Endoscopic Mucosal Resection
Publish Date 2001/11
Author Toshiyuki Mishima Digestive Endoscopy Center, JR Sendai Hospital
Author Akimichi Chonan Digestive Endoscopy Center, JR Sendai Hospital
Author Masao Ando Digestive Endoscopy Center, JR Sendai Hospital
Author Tomoyuki Tamura Digestive Endoscopy Center, JR Sendai Hospital
Author Toshihiro Kusaka Digestive Endoscopy Center, JR Sendai Hospital
Author Fukuji Mochizuki Digestive Endoscopy Center, JR Sendai Hospital
[ Summary ] We evaluated the depth of invasion of early gastric cancers, using endoscopic ultrasonography (EUS) for endoscopic mucosal resection (EMR), and compared the diagnostic ability of EUS with that of endoscopy in 182 lesions. The lesions corresponded to the indication of EMR in size, macroscopic type, microscopic type, and depth of ulceration. Because of difficulties evaluating the depth of invasion in lesions under 1mm, we devided the lesions into two categories; i.e. M-SM1 and SM2. The depth of invasion of M-SM1 cancers was less than 1mm, and that of SM2 cancers was over 1mm.
In regard to macroscopic type or site of the lesions, the accuracy rate of EUS was high, but it was not significantly different from that found with endoscopy. The number of lesions was 166 (91.2%) using EUS, and endoscopy, to correctly diagnose the depth of invasion. We encountered five lesions (2.7%) of early gastric cancers which were correctly diagnosed with EUS, but were inaccurately diagnosed with endoscopy. On the other hand, we encountered four lesions (2.2%) which were correctly diagnosed with endoscopy, but inaccurately diagnosed with EUS.
In conclusion, it can be said that we can eliminate EUS exams when evaluating of the depth of invasion of early gastric cancers with correspond to the indication for EMR.
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