%0 Journal Article
%T A new method of endoscopic ultrasonography for determining lesion depth in early gastric cancer
%A Mitsunaga A
%A Tagata T
%A Hamano T
%A Teramoto H
%J Gastrointestinal Cancer: Targets and Therapy
%D 2011
%I 
%X Atsushi Mitsunaga1, Tomoko Tagata1, Tetsuya Hamano1, Honami Teramoto1, Izumi Shirato2, Miho Shirato2, Takayoshi Nishino21Department of Endoscopy, 2Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Chiba, JapanPurpose: Endoscopic submucosal dissection (ESD) is recommended for the treatment of early gastric cancer (EGC) diagnosed as differentiated adenocarcinoma <30 mm in diameter with depth of invasion into the submucosa ¡Ü500 ¦Ìm (ie, submucosal [SM] 1 cancer). It is therefore important to develop a method for the differential diagnosis of SM1 (invasion depth ¡Ü500 ¦Ìm) from SM2/3 cancers (invasion depth >500 ¦Ìm), of which the latter cannot be treated with ESD. To aid in differential diagnosis, a prospective study was conducted to establish a new diagnostic method for more accurate differential diagnosis by measurement of lesion depth using endoscopic ultrasonography (EUS) as a preoperative diagnostic modality.Patients and methods: The lesions of 92 EGC patients were examined by EUS prior to ESD or surgery to identify and measure the area with the most thickened submucosal layer. A pathological examination of the entire resected lesion was conducted to diagnose depth of invasion and histological type of EGC. Using receiver operating characteristic analysis, a cut-off threshold of 2.2 mm for submucosal thickness was calculated for differential diagnosis of mucosal (M)-SM1 from SM2/3 cancers.Results: By using thickness of the submucosal layer as measured by EUS and a cut-off threshold of 2.2 mm, M-SM1 could be distinguished from SM2/3 cancer with 98.6% accuracy, 93.2% sensitivity, and 94.7% specificity.Conclusion: Using the thickness of the submucosal layer of an EGC lesion as determined by EUS and a cut-off threshold of 2.2 mm is a highly accurate means of differentiating M-SM1 from SM2/3 cancers when determining the best means of EGC treatment.Keywords: adenocarcinoma, depth of invasion, early gastric cancer, endoscopic submucosal dissection, endoscopic ultrasonography, submucosal thickness
%U http://www.dovepress.com/a-new-method-of-endoscopic-ultrasonography-for-determining-lesion-dept-a8962