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World J Gastrointest Endosc. Jun 16, 2012; 4(6): 218-226
Published online Jun 16, 2012. doi: 10.4253/wjge.v4.i6.218
Endoscopic ultrasound using ultrasound probes for the diagnosis of early esophageal and gastric cancers
Shigetaka Yoshinaga, Ichiro Oda, Satoru Nonaka, Ryoji Kushima, Yutaka Saito
Shigetaka Yoshinaga, Ichiro Oda, Satoru Nonaka, Yutaka Saito, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
Ryoji Kushima, Pathology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
Author contributions: Yoshinaga S performed endoscopic examinations and therapies, and also wrote this manuscript mainly; Oda I, Nonaka S and Saito Y performed endoscopic examinations and therapies; Kushima R evaluated resected specimens pathologically and took pictures of resected specimens.
Correspondence to: Dr. Shigetaka Yoshinaga, MD, PhD, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. shiyoshi@ncc.go.jp
Telephone: +81-3-35422511 Fax: +81-3-35423815
Received: October 13, 2011
Revised: April 27, 2012
Accepted: May 27, 2012
Published online: June 16, 2012
Abstract

Endoscopic ultrasound (EUS) devices were first designed and manufactured more than 30 years ago, and since then investigators have reported EUS is effective for determining both the staging and the depth of invasion of esophageal and gastric cancers. We review the present status, the methods, and the findings of EUS when used to diagnose and stage early esophageal and gastric cancer. EUS using high-frequency ultrasound probes is more accurate than conventional EUS for the evaluation of the depth of invasion of superficial esophageal carcinoma. The rates of accurate evaluation of the depth of invasion by EUS using high-frequency ultrasound probes were 70%-88% for intramucosal cancer, and 83%-94% for submucosal invasive cancer. But the sensitivity of EUS using high-frequency ultrasound probes for the diagnosis of submucosal invasive cancer was relatively low, making it difficult to confirm minute submucosal invasion. The accuracy of EUS using high-frequency ultrasound probes for early gastric tumor classification can be up to 80% compared with 63% for conventional EUS, although the accuracy of EUS using high-frequency ultrasound probes relatively decreases for those patients with depressed-type lesions, undifferentiated cancer, concomitant ulceration, expanded indications, type 0-I lesions, and lesions located in the upper-third of the stomach. A 92% overall accuracy rate was achieved when both the endoscopic appearance and the findings from EUS using high-frequency ultrasound probes were considered together for tumor classification. Although EUS using high-frequency ultrasound probes has limitations, it has a high depth of invasion accuracy and is a useful procedure to distinguish lesions in the esophagus and stomach that are indicated for endoscopic resection.

Keywords: Endoscopic ultrasound; High-frequency ultrasound probe; Esophageal cancer; Gastric cancer; Depth diagnosis