Diagnosis of Depth Invasion in Depressed Type Early Gastric Cancer: Application of Endoscopic Ultrasonography (EUS) Tsuyoshi Aibe 1 1The First Department of Internal Medicine, Yamaguchi University, School of Medicine pp.161-167
Published Date 1987/2/25
DOI https://doi.org/10.11477/mf.1403112205
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 X-ray, endoscopy and EUS were compared with respect to the accuracy rate in diagnosing depth invasion of early gastric cancer. In thirty-two cases of early cancer, the accuracy rates were 67% by x-ray, 63% by endoscopy and 69% by EUS. However, when limited to the depressed type of early cancer (16 of 32 cases), the accuracy rate obviously differs among these diagnostic modalities, i.e., 53% by either x-ray or endoscopy, and 71% by EUS.

 The only cause leading to the miss-diagnosis by EUS in the depressed type early cancer was the presence of fibrosis due to the concurrent ulcer which interrupted the submucosa on echograms. Retrospectively, it became clear that the existence of fibrosis could be diagnosed by EUS based on the shapes of the tip of the interrupted submucosa on echograms. Namely, “fusion” toward the mucosal side, “tapering” and “convex” in the tip of the interrupted submucosa were the findings characteristic to the fibrosis due to the concurrent ulcer.

 Furthermore, the muscularis propria on echograms was intact in cases with submucosal fibrosis. When the fibrosis reached to the muscularis propria, low echoic swelling or tugging toward the submucosa was seen in the muscularis propria.

 The echographical differentiation between the mucosal and the submucosal cancer in cases with fibrosis was thought to be possible by determining the presence or absence of mass suggesting tumor, at the margin of the lesion.

Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.


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