Diagnosis of the Depth of Invasion by Endoscopic Ultrasonography in Early Colorectal Carcinomas Norihiro Hamamoto 1 , Ichiro Hirata 1 , Shingo Yasumoto 1 1Second Department of Internal Medicine, Osaka Medical College Keyword: 大腸sm癌 , 深達度診断 , 超音波内視鏡 , 早期大腸癌 , EUS pp.1375-1386
Published Date 2004/9/25
DOI https://doi.org/10.11477/mf.1403100569
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 We investigated the accuracy of endoscopic ultrasonography(EUS)in diagnosing the depth of invasion of carcinomas, especially when differentiating between invasive lesions less than1,000μmdeep and other deeper lesions. The subject consisted of76mucosal cancers and70submucosal invasive cancers.

 The detection rate by EUS was77% for the protruded type and90% for the flat type. Regarding the lesions that could be detected by EUS, the diagnostic accuracy rate was83% for the protruded type and93% for the flat type, indicating that both rates were higher for the flat type.

 We attempted to calculate the depth of submucosal invasion in EUS images(of30lesions). There was a significantly positive correlation between the depth of submucosal invasion as calculated in the EUS images and that verified in histologic specimen(R=0.764, p<0.0001). In6(20%)of these30, the bottom of the second layer could be recognized in the tumor echo. In5of those6lesions, the muscularis mucosae was almost perfectly preserved and the depth of submucosal invasion was histologically calculated from the bottom of the muscularis mucosae. However, it was often difficult to confirm the layer corresponding to the muscularis mucosae in the EUS image.

 EUS is useful in the differentiation between invasive lesions less than1,000μmdeep and other deeper lesions, especially in the flat type of early colorectal carcinoma. However, it is necessary to improve the resolution of EUS in order to calculate depth of invasion in the EUS image to decide whether endoscopic resectionis indicated or not.

 1) Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan

Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.


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