Background/Aims: If a cancer lesion without ulcer can be correctly staged as mucosal, it can be a candidate for curative endoscopic treatment such as endoscopic mucosal resection. The aim of this study was to evaluate the usefulness of EUS and endoscopy in diagnosing mucosal cancer of stomach.
Methods: Findings of endoscopy and EUS were independently reviewed by the conventional criteria for diagnosing depth of invasion and compared with histologic findings in 65 patients having EGC without ulcers.
Results: Overall accuracy of diagnosing depth of invasion were 69% by endoscopy and 78% by EUS. The accuracy rates according to the macroscopic type by endoscopy were 86% (12/14) for type Ⅰ, 75% (3/4) for type Ⅱa, 75% (9/12) for type Ⅱa+Ⅱc, 50% (2/4) for type Ⅱc+Ⅱa, 66% (19/29) for type Ⅱc and 0% (0/2) for type Ⅱc+Ⅱb. The accuracy rates according to the macroscopic type by EUS were 93% (13/ 14) for type Ⅰ, 50% (2/4) for type Ⅱa, 75% (9/12) for type Ⅱa+Ⅱc, 50% (2/4) for type Ⅱc+Ⅱa, 83% (24/29) for type Ⅱc and 50% (1/2) for type Ⅱc+Ⅱb. All lesions that were classified as limited to the mucosa on both conventional endoscopy and EUS in type Ⅰ (n=9), Ⅱa (n=2), Ⅱa+Ⅱc (n=2) and Ⅱc (n=11) were limited to the mucosa by histologic findings.
Conclusions: This study suggests that if both modalities show the findings of mucosal lesion in type Ⅰ and Ⅱc of EGC, endoscopic mucosal resection may be considered as a curative treatment.
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