W Guo1, Y L Zhang1, G X Li1, D Y Zhou1, W D Zhang1. 1. Wen Guo, Ya-Li Zhang, Dian-Yuan Zhou, Wan-Dai Zhang, PLA Research Institute for Digestive Diseases, Department of General Surgery, Nanfang Hospital, Guangzhou 510515, Guangdong Province, China.
Abstract
AIM: To assess the accuracy and limitations of endoscopic ultrasonography (EUS) in the preoperative staging of gastric carcinoma in comparison with computed tomography (CT). METHODS: According to the new (1987) TN staging, 62 patients with gastric carcinomas were examined preoperatively by EUS and the results compared with those of postoperative pathological TN staging. CT of abdomen was performed before surgery for 32 of the patients. RESULTS: The overall accuracy of T staging was 83.9% for EUS and 28.1% for CT. For the detection of regional lymph node metastases, EUS accuracy was 79.0%, sensitivity 80.0% and specificity 87.5%, versus 50.0% accuracy for CT. The coincidence of perigastric infiltration was 90.0% for EUS and 41.2% for CT. The most frequent causes of misdiagnosis by EUS were microscopic tumor invasion and peritumorous inflammatory or fibrous changes. CONCLUSION: EUS is a reliable method for the clinical evaluation of locoregional extension of gastric cancer and more accurate than CT in the preoperative staging of gastric carcinoma.
AIM: To assess the accuracy and limitations of endoscopic ultrasonography (EUS) in the preoperative staging of gastric carcinoma in comparison with computed tomography (CT). METHODS: According to the new (1987) TN staging, 62 patients with gastric carcinomas were examined preoperatively by EUS and the results compared with those of postoperative pathological TN staging. CT of abdomen was performed before surgery for 32 of the patients. RESULTS: The overall accuracy of T staging was 83.9% for EUS and 28.1% for CT. For the detection of regional lymph node metastases, EUS accuracy was 79.0%, sensitivity 80.0% and specificity 87.5%, versus 50.0% accuracy for CT. The coincidence of perigastric infiltration was 90.0% for EUS and 41.2% for CT. The most frequent causes of misdiagnosis by EUS were microscopic tumor invasion and peritumorous inflammatory or fibrous changes. CONCLUSION: EUS is a reliable method for the clinical evaluation of locoregional extension of gastric cancer and more accurate than CT in the preoperative staging of gastric carcinoma.