CLINICAL EVALUATION OF ENDOSCOPIC ULTRASONOGRAPHY (EUS) IN THE DIAGNOSIS OF DEPRESSED TYPE EARLY GASTRIC CANCERS

Abstract

To evaluate the ability of endoscopic ultrasonography (EUS) in diagnosing the depth of invasion of depressed type early gastric cancers, 200 cases examined by EUS were evaluated.
Classificatin based on fibrosis pattern was histopathologically suggested : (1) group F (-), fibrosis was not visible ; (2) group Fsm, fibrosis was limited to sm layer ;(3) group Fpm ≤, fibrosis was visible in pm layer or more (Figure 1). The results were as follows; 1) In group F (-), there was no change of the third layer or more in m or sml cancer. But interruption of the third layer was shown in sm2 cancer (Figure 2, Table 3). In group Fsm, gastric wall of m or sml cancer showed no thickening or inward growth only. On the other hand, sm2 cancer showed both the inward and outward growth (Figure 3, 4, Table 4). In group Fpm≤, m or sml cancer showed no thickening of gastric wall or inward growth only (Figure 3, 4, Table 4).
2) According to these indices, EUS classification of depressed type early gastric cancers was proposed (Figure 5). In group F (-), the depth of invasion was accurately diagnosed by EUS, 84.1% in m cancer, 75.0% in sml cancer and 83.3% in sm2 cancer, respectively. In group Fsm, the depth of invasion was accurately diagnosed, 81.7% in m cancer, 83.3% in sml cancer and 72.2% in sm2 cancer, respectively. In group Fpm, the depth of invasion was accuratelly diagnosed, 100% in m cancer and 75.0% in sml cancer except for the cancerous foci associated with open ulcer.
3) It was suggested that the ability of EUS diagnosis for the depth of invasion in depressed type early gastric cancers was improved.