Background: Early gastric cancers (EGCs) are defined as those with malignant growths in the mucosa (T1m) and submucosa (T1sm). T1m can be treated by endoscopic mucosal resection (EMR), thus avoiding gastrectomy. The aim here was to determine whether the use of a 20-MHz endoscopic ultrasonic probe (EUSP) could aid in the differentiation of T1m EGC for EMR, and T1sm for gastrectomy. Materials and Methods: From September 1997 to February 1998, five cases of EGC were enrolled to receive tumor staging by endoscopic ultrasonography using an EUSP inserted via the biopsy channel of an endoscope. Based on the tumor size and stage, determined by use of the EUSP and categorized as T1m or T1sm, EMR was carried out for suitable T1m cancers using a two-channel method. In those cases unsuitable for EMR, open surgery was performed. The resected specimens from both EMR and open surgery were submitted for histopathologic confirmatory staging. Results: Three of the five EGC cases, including two correctly staged as T1m and one equivocally overstaged as T1sm using the EUSP, underwent EMR. All three cases were confirmed as being T1m by pathology and curatively resected by EMR. The remaining two cases, including one understaged on endoscopy, were both correctly staged as T1sm using the EUSP. Conclusion: The 20-MHz EUSP is an effective aid in endoscopic staging for the depth of tumor invasion in EGC and in the selection of mucosal EGC for EMR and submucosal EGC for gastrectomy. Whenever equivocal staging is encountered using an EUSP, EMR is advised for both the diagnostic and therapeutic benefits.
|Number of pages||6|
|Journal||Journal of Medical Ultrasound|
|Publication status||Published - 1998 Jan 1|
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging