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首页> 外文期刊>Surgical Endoscopy >Is endoscopic ultrasonography indispensable in patients with early gastric cancer prior to endoscopic resection?
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Is endoscopic ultrasonography indispensable in patients with early gastric cancer prior to endoscopic resection?

机译：早期胃癌患者在内镜切除之前，内镜超声检查是否必不可少？

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BACKGROUND: Endoscopic resection as curative treatment of early gastric cancer (EGC) requires accurate staging for depth of invasion (T) before therapy. This study aimed to compare T staging of EGC using a miniprobe with that of conventional endoscopy (CE). METHODS: A total of 388 patients with suspected of EGC by CE were prospectively enrolled in the study. After miniprobe staging by an experienced endosonographer, CE staging was performed by another endoscopist who was blinded to the miniprobe assessment. Patients underwent either endoscopic resection (n = 325) or surgery (=63) according to staging results. Results of each method were compared with the histology of the resected specimen. Clinicopathological factors affecting accuracy of each test were also evaluated. RESULTS: Overall accuracy of miniprobe and CE staging was 78.9% (306/388) and 81.4% (316/388), respectively (p = 0.052). Sensitivity for T1m was more than 95% (miniprobe 98.7%, CE 97.7%), whereas sensitivity for T1sm was lower at 6.6% for miniprobe and 23.7% for CE (p = 0.002). Among nine lesions identically considered submucosal invasion by both methods, three were T1sm cancer. Diagnostic accuracy of the miniprobe was lower than that of CE with respect to lesions located in the lower third of the stomach, differentiated histology, or massive submucosal invasion. CONCLUSIONS: Overall accuracy of the miniprobe and CE for T staging in EGC was approximately 80% with no significant difference. Accurate prediction of both techniques for submucosal invasion was poor, even by using a combination of the two methods. The use of the miniprobe may not increase the positive predictive value for T staging over the use of CE alone.
机译：背景：内镜切除术作为早期胃癌（EGC）的治愈性治疗，需要在治疗前准确分期确定浸润深度（T）。这项研究旨在比较使用微型探头与常规内窥镜检查（CE）进行的EGC的T分期。方法：前瞻性纳入了388例CE怀疑为EGC的患者。在由经验丰富的内窥镜检查医师进行迷你探针分期后，另一位对迷你探针评估不知情的内镜医师进行了CE分期。根据分期结果，患者接受内窥镜切除术（n = 325）或手术（= 63）。将每种方法的结果与切除标本的组织学进行比较。还评估了影响每个测试准确性的临床病理因素。结果：微型探针和CE分期的总体准确性分别为78.9％（306/388）和81.4％（316/388）（p = 0.052）。 T1m的敏感性高于95％（微型探针98.7％，CE为97.7％），而T1sm的敏感性则为6.6％（微型探针）和23.7％（CE）（p = 0.002）。在两种方法均被视为粘膜下浸润的9个病变中，有3个为T1sm癌。对于位于胃下三分之一处的病变，分化的组织学或大量的粘膜下浸润，微型探头的诊断准确性低于CE。结论：迷你探针和CE在EGC中进行T分期的总体准确性约为80％，差异无统计学意义。即使同时使用两种方法，对粘膜下浸润的两种技术的准确预测也很差。与仅使用CE相比，使用迷你探针可能不会增加T分期的阳性预测价值。

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