Japanese

The Role of Radiological Diagnosis of the Depth of Invasion in Early Gastric Cancer in the ESD Age Shunji Shimaoka 1 , Akio Matsuda 1 , Tatsuyuki Nioh 1 , Saori Iifuku 1 , Yukiko Baba 1 , Tae Shamoto 1 , Mari Toyoda 1 , Kosuke Iwaki 1 , Nobuaki Nishimata 1 , Koichiro Tsukasa 1 , Koutaro Tashiro 1 , Tohru Niihara 1 , Yoshito Nishimata 1 , Masahide Hori 1 , Hiroto Nishimata 1 , Sadao Tanaka 2 1Department of Gastroenterology, Kagoshima Nanpuh Hospital, Kagoshima, Japan 2Department of Diagnostic Pathology, Kagoshima Nanpuh Hospital, Kagoshima, Japan Keyword: 早期胃癌 , 深達度診断 , ESD , X線検査 , EUS pp.22-33
Published Date 2014/1/25
DOI https://doi.org/10.11477/mf.1403114044
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 Aims : To clarify the role of radiological examination in diagnosis of the depth of invasion of early gastric cancer in the ESD age.

 Methods : We investigated 287 early gastric carcinoma cases that had been treated by ESD or surgery. Endoscopic, Radiological, EUS findings that indicated SM2 carcinoma were set beforehand respectively. The accuracy of the diagnosis and the additional diagnostic value of radiological and EUS diagnosis were investigated.

 Results : The accuracy rates of endoscopic diagnosis were high enough to decide the indications of ESD in the lesions 30mm or less in size that were differentiated type without UL. However in the lesions larger than 30mm and differentiated type with UL, the accuracy rates were lower than in the lesions without UL because of over-diagnosis. Even in such lesions, using radiological diagnosis, the accuracy rates rose enough to decide the indication of ESD. The accuracy rates of endoscopic diagnosis in the lesions larger than 30mm, differentiated type without UL were lower than in the lesions equal or less than 30mm because of under-diagnosis. The accuracy rates rose using radiological diagnosis in such lesions. In the lesions equal to or less than 20mm, and in undifferentiated types without UL, the accuracy rates of endoscopic diagnosis were high enough to decide the indications of ESD. EUS was useful in the upper gastric lesions where compression methods could not be used in radiological examinations.

 Conclusions : Radiological examinations were useful(in large lesions that were under-diagnosed in endoscopy)to avoid unnecessary ESD and in the lesions without UL(that were over-diagnosed in endoscopy)to avoid unnecessary surgery. Even in the ESD age, it is important to use endoscopy, radiological examination, and EUS complementarily according to the types of lesions to get sufficient information for deciding treatment strategy.


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

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