Japanese

Assessment of the Depth of Invasion of Gastric Carcinoma by Endoscopic Ultrasonography (EUS) Focused on Peptic Ulceration within Cancerous Areas Tsuneya Nakamura 1 , Takashi Suzuki 1 , Akira Matsuura 1 , Kazuhiko Ohashi 1 1Department of Gastroenterology, Aichi Cancer Center Hospital Keyword: 超音波内視鏡 , 胃癌 , 深達度 , 病巣内潰瘍 , 線維化 pp.1105-1117
Published Date 1999/8/25
DOI https://doi.org/10.11477/mf.1403102800
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 The ability of EUS to diagnose the depth of invasion was investigated in 325 patients with gastric carcinoma, consisting of 181 early cancers and 144 advanced cancers. The depth of invasion of gastric carcinoma was classified as the mucosa (m), submucosa (sm), and muscularis propria (mp) or more advanced invasion.

 Moreover, the depth of invasion into the submucosa was divided into three subtypes (sm1, sm2, sm3). Invasion of sm1 was defined to be limited within 1 mm below the muscularis mucosae. Invasion of sm3 was defined to be close above the muscularis propria. The depth of invasion of sm2 was between sm1 and sm3.

 The results obtained were as follows;  1) The overall diagnostic accuracy was 81% in all 325 cases; 74% in m cancers, 71% in sm cancers and 91% in mp or more advanced cancers, respectively. Rates peptic ulceration within cancerous areas were 45% (47/104) in m cancers and 21% (16/77) in sm cancers. The fan-like appearance of hypoechoic area in the 3rd or more deeper layer corresponded with fibrosis caused by peptic ulceration in cancerous area. It was difficult to differentiate cancerous invasion from fibrosis caused by peptic ulceration of which EUS finding had no fan-like appearance.

 2) The diagnostic accuracy of EUS was superior to those of roentgenography and endoscopy in the following cases; the cases of which the cancerous lesion was located at the lower or middle gastric body, the cases, in all size or in both protruded and excavated types of gross appearance, of which the depth of invasion was sm, and the cases without peptic ulceration in the lesion, of which the depth of invasion was either sm1 or sm3. However, the diagnostic accuracy of EUS was as poor as those of roentgenography and endoscopy in the cases of gastric carcinoma with peptic ulceration in cancerous area.


Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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