Clinical Trials Study
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World J Gastroenterol. May 28, 2014; 20(20): 6322-6328
Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.6322
Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma
Jung Im Jung, Gwang Ha Kim, Hoseok I, Do Youn Park, Tae Kyun Kim, Young Hwa Cho, Yong Wan Sung, Mun Ki Choi, Bong Eun Lee, Geun Am Song
Jung Im Jung, Gwang Ha Kim, Tae Kyun Kim, Young Hwa Cho, Yong Wan Sung, Mun Ki Choi, Bong Eun Lee, Geun Am Song, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, South Korea
Hoseok I, Department of Chest Surgery, Pusan National University School of Medicine, Busan 602-739, South Korea
Do Youn Park, Department of Pathology, Pusan National University School of Medicine, Busan 602-739, South Korea
Author contributions: Kim GH, I H and Park DY designed the research/study; Jung JI analyzed the data; Jung JI and Kim GH performed the study; Kim TK, Cho YH, Sung YW, Choi MK and Lee BE collected the data; Song GA reviewed the data of study population; Jung JI and Kim GH wrote the paper.
Supported by A grant of the Korea Healthcare Technology R and D Project, Ministry of Health and Welfare, Republic of Korea, No. A121994
Correspondence to: Gwang Ha Kim, MD, PhD, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan 602-739, South Korea. doc0224@pusan.ac.kr
Telephone: +82-51-2407869 Fax: +82-51-2448180
Received: November 29, 2013
Revised: January 27, 2014
Accepted: March 4, 2014
Published online: May 28, 2014
Abstract

AIM: To identify clinicopathologic factors influencing the accuracy of a high-frequency catheter probe endoscopic ultrasonography (EUS) for superficial esophageal carcinomas (SECs).

METHODS: A total of 126 patients with endoscopically suspected SEC, who underwent EUS and curative treatment at Pusan National University Hospital during 2005-2013, were enrolled. We reviewed the medical records of the 126 patients and compared EUS findings with histopathologic results according to clinicopathologic factors.

RESULTS: A total of 114 lesions in 113 patients were included in the final analysis. The EUS assessment of tumor invasion depth was accurate in 78.9% (90/114) patients. Accuracy did not differ according to histologic type, tumor differentiation, tumor location, or macroscopic shape. However, accuracy significantly decreased for tumors ≥ 3 cm in size (P = 0.002). Overestimation and underestimation of the invasion depth occurred for 11 (9.6%) and 13 lesions (11.4%), respectively. In multivariate analyses, tumor size ≥ 3 cm was the only factor significantly associated with EUS accuracy (P = 0.031), and was specifically associated with the underestimation of invasion depth.

CONCLUSION: EUS using a high-frequency catheter probe generally provides highly accurate assessments of SEC invasion depth, but its accuracy decreases for tumors ≥ 3 cm.

Keywords: Esophageal cancer, Endoscopic ultrasonography, Accuracy

Core tip: Endoscopic ultrasonography (EUS) using a high-frequency catheter probe generally provides a highly accurate assessment of the invasion depth of superficial esophageal cancers (SECs). However, accuracy decreases for tumors ≥ 3 cm in size, with a tendency towards underestimation for these tumors. Therefore, caution is warranted when selecting the treatment modality for SECs ≥ 3 cm in size on the basis of pretreatment EUS staging.