Brief Article
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World J Gastroenterol. Feb 7, 2014; 20(5): 1340-1347
Published online Feb 7, 2014. doi: 10.3748/wjg.v20.i5.1340
Endoscopic ultrasonography for staging of T1a and T1b esophageal squamous cell carcinoma
Long-Jun He, Hong-Bo Shan, Guang-Yu Luo, Yin Li, Rong Zhang, Xiao-Yan Gao, Guo-Bao Wang, Shi-Yong Lin, Guo-Liang Xu, Jian-Jun Li
Long-Jun He, Hong-Bo Shan, Guang-Yu Luo, Yin Li, Rong Zhang, Xiao-Yan Gao, Guo-Bao Wang, Shi-Yong Lin, Guo-Liang Xu, Jian-Jun Li, Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, Guangzhou 510060, Guangdong Province, China
Long-Jun He, Hong-Bo Shan, Guang-Yu Luo, Yin Li, Rong Zhang, Xiao-Yan Gao, Guo-Bao Wang, Shi-Yong Lin, Guo-Liang Xu, Jian-Jun Li, Department of Endoscopy, State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong Province, China
Long-Jun He, Hong-Bo Shan, Guang-Yu Luo, Yin Li, Rong Zhang, Xiao-Yan Gao, Guo-Bao Wang, Shi-Yong Lin, Guo-Liang Xu, Jian-Jun Li, Department of Endoscopy, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong Province, China
Author contributions: Li JJ designed and was responsible for the study; Shan HB, Luo GY, Li Y, Zhang R, Gao XY, Wang GB and Lin SY acquired, analyzed and interpreted data; Li JJ, Shan HB and He LJ drafted and revised the masucript; Xu GL served as an advisor; all authors approved the final vision to be published.
Supported by Science and Technology Plan Projects of Guangdong Province, China, No.2011B080701015 and No. 2012B061700076
Correspondence to: Jian-Jun Li, MD, PhD, Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, 651 Dongfeng Road East, Guangzhou 510060, Guangdong Province, China. lijj@sysucc.org.cn
Telephone: +86-20-87343383 Fax: +86-20-87343224
Received: August 15, 2013
Revised: September 24, 2013
Accepted: September 29, 2013
Published online: February 7, 2014
Abstract

AIM: To investigate the accuracy of Endoscopic ultrasound (EUS) in staging and sub-staging T1a and T1b esophageal squamous cell carcinoma (ESCC).

METHODS: A retrospective analysis involving 72 patients with pathologically confirmed T1a or T1b ESCC, was undertaken between January 2005 and December 2011 in Sun Yat-sen University Cancer Center. The accuracy and efficiency of EUS for detecting stages T1a and T1b ESCC were examined.

RESULTS: The overall accuracy of EUS for detecting stage T1a or T1b ESCC was 70.8% (51/72), and the sensitivity was 74.3%. 77.8% (7/9) of lesions originated in the upper thoracic region, 73.1% (38/52) in the mid-thoracic region and 72.7% (8/11) in the lower thoracic region. Multivariate analysis revealed that the diagnostic accuracy of EUS was closely related to lesion length (F = 4.984, P = 0.029).

CONCLUSION: EUS demonstrated median degree of accuracy for distinguishing between stages T1a and T1b ESCC. Therefore, it is necessary to improve EUS for staging early ESCC.

Keywords: Endoscopic ultrasound, Esophageal cancer, Squamous carcinoma, Early cancer, Stage

Core tip: Endoscopic ultrasound (EUS) is the best option for staging early esophageal squamous cell carcinoma (ESCC). However, the accuracy of EUS for staging ESCC is not good and diverse. There is no other report about sub-staging T1 disease as T1a or T1b by EUS for ESCC. This study indicated that accuracy demonstrated by EUS for sub-staging T1a and T1b ESCC was only about 70%. Therefore, the technique of EUS requires further refinement to enhance its diagnostic accuracy for staging early ESCC. The results in this study indicated that EUS can stage and sub-stage early ESC pre-operatively whereas this modality need to be improved.