The preoperative staging of gastric cancer is of great importance in determining the operative strategies. Computerized tomography (CT) has been widely used for this purpose, although this method is of limited value. Endosonogrphy (EUS), a new
imaging
method, has been known to be accurate in assessing the extent and depth of tumor infiltration and adjacent lymph node involvement.
The purpose of this study were to evaluate the accuracy and limitation of EUS and to compare EUS with CT in the preoperative staging of gastric cancer.
Thirty-one patients with gastric cancer underwent operations at the Department of Surgery, Korea Veterans Hospital from July 1992 to February 1994. EUS and CT were used to stage gastric cancer preoperatively according to the TNM staging
classification
of the Americans were seperately compared with the pathologic TNM staging classification of the resected specimens. In the assessment of the extent and depth of tumor infitration in gastric was (T). the overall accuracy of EUS and CT were 83% and
50%,
respectively. The accuracy of EUS were 83% at T1 or T2, 89% at T3 and 20% at T4 stage, respectively. In staging T, EUS overstage 2 pateints and understage 5 patients. By contrast. CT overstage 10 patients and understage 5 patients. In the
evaluation of
perigastric lymph node metastasis (N), the accuracy of EUS was 68% and sensitivity and specificity were 64% and 85%, respectively. The positive and negative predictive values of EUS predicting perigastric lymph node metastasis were 70% and 80%,
respectively. The positive and negative predictive values of CT were 36% and 67%, respectively.
In conclusion, this study suggested that EUS may be more accurate than CT in assessing the extent and depth o tumor infiltration and detecting the perigastric lymph node metastasis, Thus we believe that EUS will become a standard imaging
technique
in
the preoperative staging gastric cancer and follow-up after operation.
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