Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer

Table 1 Relationship between EUS and anatomic layers of normal gastric wall

EUS	Histology
1st hypoechoic layer	Water interface and superficial mucosa
2nd hypoechoic layer	Deeper mucosa
3rd hyperechoic layer	Submucosa
4th hypoechoic layer	Muscularis propria
5th hyperechoic layer	Serosa and subserosal fat

Table 2 Correlation of UICC/AJCC classification for depth of primary esophageal or gastric cancer invasion (T) with EUS imaging for clinical staging[9]

Stage	EUS (abnormal)
T1-mucosa/submucosa	1st three layers
T2-muscularis propria	4th layer
T3-through adventitia/serosa	5th layer
T4-adjacent organ	Adjacent organ

Table 3 Accuracy of EUS in preoperative stage determination of 41 patients with gastric cancer

Histopathological T stage	n	EUS correct n/%	EUS overstaging n/%	EUS understaging n/%
PT1	12	T1 10/83.3	T2 2/16.7	-
PT2	20	T2 12/60	T3 8/40	-
PT3	5	T3 5/100	-	-
PT4	4(3)	T4 1/25	-	T2 2 (2)/50
				T3 1 (1)/25
Total	41(3)	28/68.3	10/24.4	3 (3)/7.3

Three cases of unresectable T4 N+ tumors were correctly diagnosed.

Table 4 Accuracy of EUS in preoperative determination of N stage in 41 patients with gastric cancer

Histopathological N stage	n	EUS correct n/%	EUS incorrect n/%
PN0	17	N 17/100	-
PN+	24(3)	N+ 10 (3)/41.7	N0 14/58.3 false negative
All cases	41(3)	27 (3)/66	14/34

Table 5 Literalure summary of EUS studies on gastric cancer

	Author	Period	Number of patients	Accuracy (%)
				T stage	N stage
1	Botet et al.[11] (USA)	1986–1988	50	92	78
2	Akahoshi et al.[12] (Japan)	1986–1990	74	81.1	50
3	Ziegler et al.[10] (Germany)	1986–1990	108	86	74
4	Lightdale[13] (USA)	1989–1991	525	81	76
5	Dittler et al[14] (Germany)	1989–1992	264	83	66
6	Francois et al.[15] (France)	1991–1993	35	79	79
7	Yanai et al.[16] (Japan)	1990–1995	104	64.8	Early stage
8	Meining et al.[17] (Germany)	1992–1996	33	66	Not reported
9	Yanai et al.[18] (Japan)	1996–1997	52	71	Early stage
10	Guo et al.[19] (China)	1996–1997	62	83.9	79
11	Hunerbein et al.[20] (Germany)	19971	30	82	80
12	Habermann et al.[21] (Germany)	1998–2000	51	86	90
13	Hizawa et al.[22] (Japan)	1997–2002	234	78	Early stage
14	Xi et al.[23] (China)	20021	32	80	68.6
15	Shimoyama et al.[24] (Japan)	1996–2003	45	71	80
16	Bhandari et al.[9] (Korea)	2003	63	87.5	79.1

¹Year of article publication/duration of study not reported.