Endoscopic ultrasonography(EUS) has been used in assessing the depth of cancer invasion of the stomach. To find out the factors affecting the diagnostic accuracy of EUS in determining the depth of cancer invasion, we analysed 116 cases of gastric
cancer
performed EUS. One hundred and sixteen cases who were operated for gastric cancer were evaluated by EUS prior to operation. EUS was performed with a 7.5 MHz Olympus EUS. The results were compared with the depth of cancer invasion of the resected
specimen and analysed the pathologic findings in mis-staging cases. The degree of vertical invasion of gastric cancer was classified into 4 stages : mucosa, submucosa, muscularis propria, and serosa. Overall accuracy of EUS in determining the
depth
of
cancer invasion was 67.2%(78 to 116 cases). The diagnostic accuracy in the depth of tumor invasion showed no difference in relation to location of tumor, histologic type, and degree of differentiation. In contrast, the diagnostic accuracy was
higher in
small size(less than 4cm) of tumor than large size(more than 4cm) of tumor, and in non-ulcerative type than ulcerative type in early gastric cancer. In advanced gastric cancer, the diagnostic accuracy was higher in large size(more than 6cm) of
tumor
than small size(less than 2cm) of tumor. The main pathologic findings of overstaging were fibrosis coexisting ulcer and compression of adjacent layer by the tumor, and understaging was microinvasion of cancer. (Korean J Gastroenterol 1994 ; 26 :
806-815)
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