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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 245390, 4 pages
http://dx.doi.org/10.1155/2012/245390
Clinical Study

Accuracy of Endoscopic Ultrasonography for Determining the Treatment Method for Early Gastric Cancer

Department of Gastroenterology, Kyoto Second Red Cross Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto 602-8026, Japan

Received 15 March 2012; Revised 6 October 2012; Accepted 29 October 2012

Academic Editor: Manoop Bhutani

Copyright © 2012 Koichiro Mandai and Kenjiro Yasuda. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Endoscopic resection (ER) for early gastric cancer (EGC) is a minimally invasive and curative treatment. The value of endoscopic ultrasonography (EUS) in determining the therapeutic strategy for EGC was assessed in this study. Materials and Methods. Pretreatment EUS was performed on 406 EGCs. The lesions were divided into the histological categories m/sm1 and sm2. The EUS-determined depths of invasion were classified as EUS-M/SM1, EUS-SM2, and EUS-MP or deeper. An analysis of the factors influencing the EUS-based depth determination was then conducted. Results. Most (92.8%) of the EUS-M/SM1 group belonged to the m/sm1 histological category. Ulcerated lesions, tumor size of larger than 2 cm, and the use of an ultrasound endoscope were independently associated with misdiagnosis of the depth of EGC by EUS. The ulcerated lesions had a significantly higher probability of overestimation. Conclusions. EUS is a useful method for determining the therapeutic strategy for EGC. Special attention should be paid not to overestimate the depth of cancer invasion when determining the ulcerated lesions and the type of curative procedure to be used.