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KMID : 0359019930130030545
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Korean Journal of Gastrointestinal Endoscopy
1993 Volume.13 No. 3 p.545 ~ p.550
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Pathologic Findings Affecting the Diagnostic Accuracy in Determining the Depth of Invasion of Gastric Cancer by Endoscopic Ultrasonography(EUS)
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정재복
천상배/송시영/문영명/강진경/박인서/김명욱/한지영/박찬일
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Abstract
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Endoscopic ultrasonography (EUS) has been used in assessing the depth of cancer invasion of the stomach. However, there are pathologic findings coexisting cancers which are unable to be detected by EUS resulting in mis-staging preoperatively. To
find
out the causes of mis-staging in determining the depth of cancer invasion, we analysed the pathologic findings of mis-staged cases of gastric cancer by EUS
Ninety one cases who were operated for gastric cancer were evaluated by EUS prior to operation. EUS was performed with a 7.5 MHz Olympus endoscopic ultrasonography(EU-M3). The results were compared with the depth of cancer invasion of the
resected
specimen and analysed the pathologic findings in mis-staged cases. The degree of vertical invasion of gastric cancer was classified into 4 stages: mucosa, submucosa, muscularis propria and deeper than subserosa.
Overall accuracy of EUS in determining the depth of cancer invasion was 68.1%(62 of 91 cases). Among the 29 cases of mis-staging, the local extent of cancer infiltration was overstaged in 22 cases and understaged in 7 cases. The main pathologic
findings
of overstaging were fibrosis coexisting ulcerative cancer(10 of 22 cases) and compression of adjacent layer by the tumor95 of 22 cases). The main pathologic finding of understaging was microinvasion of cancer(6 of 7 cases).
In conclusion, to improve the diagnostic accuracy of EUS in determining the depth of cancer invastion further studies are needed to differentiate cancer and fibrosis, and to find out the method to detect microinvasion of cancer.
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KEYWORD
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