Endoscopy 2010; 42(9): 705-713
DOI: 10.1055/s-0030-1255617
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Comparison of endoscopic ultrasonography and conventional endoscopy for prediction of depth of tumor invasion in early gastric cancer

J.  Choi1 , S.  G.  Kim1 , J.  P.  Im1 , J.  S.  Kim1 , H.  C.  Jung1 , I.  S.  Song1
  • 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
Further Information

Publication History

submitted 30 December 2009

accepted after revision 20 May 2010

Publication Date:
22 July 2010 (online)

Background and study aims: This study aimed to compare the diagnostic accuracy of endoscopic ultrasonography (EUS) with that of conventional endoscopy for staging depth of invasion (T staging) in early gastric cancer.

Patients and methods: A total of 955 patients with suspected early gastric cancer were prospectively registered. EUS staging was carried out prospectively by a single endoscopist using either miniprobe or radial EUS depending on the endoscopic appearance of the tumor. Conventional endoscopy staging was performed retrospectively by consensus between two endoscopists who were blinded to the EUS staging. Conventional endoscopy staging was conducted on the basis of endoscopic features such as surface nodularity and fold convergence. Patients underwent either surgical (n = 586) or endoscopic resection (n = 369) with curative intent. The staging accuracy of each test was compared with the pathological staging of the resected specimen.

Results: The presence of a T1m tumor was histologically confirmed in 644 cases (67.4 %) and that of a T1sm tumor in 311 cases (32.6 %). The overall accuracy of EUS staging was 67.4 % (644 / 955) and that of conventional endoscopy staging was 73.7 % (704 / 955) (P < 0.001). The accuracy of miniprobe EUS was significantly higher than that of radial EUS (79.5 % vs. 59.6 %, P < 0.001), but did not differ significantly from that of conventional endoscopy (79.0 %).

Conclusions: EUS does not substantially impact on pretreatment T staging of patients with early gastric cancer compared with conventional endoscopy. Therefore, EUS may not be necessary routinely, and conventional endoscopy may be sufficient for determining the optimal therapeutic strategy, especially in relation to endoscopic resection for early gastric cancer.

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S. G. KimMD, PhD 

Division of Gastroenterology
Department of Internal Medicine and Liver Research Institute
Seoul National University College of Medicine

Yongun-dong 28, Chongno-gu
Seoul 110-744
South Korea

Fax: +82-2-7436701

Email: harley1333@hanmail.net