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Clinical efficacy of endoscopic ultrasonography for decision of treatment strategy of gastric cancer

机译：内镜超声检查胃癌治疗策略决策的临床疗效

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摘要

Background Accurate preoperative tumor staging of gastric cancer is indispensable with expansion of indications for laparoscopic surgery and endoscopic resection. It is important to distinguish mucosal cancer (T1a) in smaller lesion and differentiate early gastric cancer (EGC) in larger lesion considering endoscopic resection indication and laparoscopic surgery indication. We evaluated the clinical outcomes of endoscopic ultrasonography (EUS) for the decision of treatment strategy of gastric cancer compared with pathological staging. Methods The patients who underwent EUS and surgical or endoscopic resection for gastric cancer were retrospectively reviewed between September 2005 and February 2016. The depth of tumor invasion (T staging) by EUS was compared with the pathological staging after endoscopic or surgical resection. Results A total of 6084 patients were finally analyzed. The accuracy rates for T1a and EGC were 75.0 and 89.4%, respectively. The overall accuracy of T staging by EUS was 66.3% when divided by T1a, T1b, and over T2. The accuracy of EUS prior to endoscopic resection was 75.1% in absolute indication and 73.1% in expanded criteria, respectively. The accuracy rates for T1a with lesion ≤?2?cm in miniprobe EUS and EGC with lesion >?2?cm in conventional EUS were 84.6 and 83.2%, respectively. In multivariate analysis, presence of ulcer, large tumor size, and radial EUS were associated with overestimation, and small tumor size and miniprobe were associated with underestimation in T staging. Conclusions EUS showed the high accuracy of 84.6% for T1a in lesion ≤?2?cm in miniprobe EUS and 83.2% for EGC in lesion >?2?cm in conventional EUS, respectively. EUS can be a complementary diagnostic method to determine endoscopic or surgical treatment modality.
机译：背景技术胃癌的准确术前肿瘤分期对于腹腔镜手术和内镜切除的适应症是必不可少的。重要的是在考虑内窥镜切除指示和腹腔镜手术指示中，在较小的病变中区分粘膜癌（T1A）在较小的病变和分化早期胃癌（EGC）中。我们评估了内镜超声（EUS）的临床结果，了解胃癌治疗策略与病理分期相比。方法回顾性审查了2005年9月至2016年2月的胃癌eus和外科手术或内镜切除患者。与内窥镜或手术切除后的病理分期进行了与eus的肿瘤侵袭（t暂停）的深度。结果总共分析了6084名患者。 T1A和EGC的精度分别为75.0和89.4％。当通过T1A，T1B和T2除以时，EUS的T分期的整体准确性为66.3％。内窥镜切除前EUS的精度分别为绝对指示的75.1％，分别为膨胀标准的73.1％。在MiniProbe EUS和EGC中具有病变≤α2Ω·2Ω·2Ω·2Ω·2Ω··2m的≤α2Ω·2μm的精度率分别为84.6％和83.2％。在多变量分析中，存在溃疡，大肿瘤大小和径向eU的存在与估计有关，并且小肿瘤大小和小型细胞与T阶段低估有关。结论EUS在小型瓣屈光度≤α2Ω·2Ω·2Ω·2Ω·2厘米的高精度为84.6％，分别在常规EUS中的损伤中的eGC中的83.2％。 EUS可以是确定内窥镜或手术治疗方式的互补诊断方法。

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  • 来源
    《Surgical Endoscopy》 |2018年第9期|共9页
  • 作者

    Jung Kim; Sang Gyun Kim; Hyunsoo Chung; Joo Hyun Lim; Ji Min Choi; Jae Yong Park; Hyo-Joon Yang; Seung Jun Han; Sooyeon Oh; Min Seong Kim; Hyun Ju Kim; Hyoungju Hong; Hee Jong Lee; Jue Lie Kim; Eunwoo Lee; Hyun Chae Jung;

  • 作者单位

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine Healthcare Research Institute Healthcare System Gangnam Center;

    Department of Internal Medicine Healthcare Research Institute Healthcare System Gangnam Center;

    Department of Internal Medicine Chung-Ang University Hospital;

    Division of Gastroenterology Department of Internal Medicine and Gastrointestinal Cancer Center;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

    Department of Internal Medicine and Liver Research Institute Seoul National University College of;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Endoscopic ultrasonography; Gastric cancer; Tumor staging;

    机译：内窥镜超声检查;胃癌;肿瘤分期;

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