Abstract
The purpose of this study was to evaluate the effectiveness of endoscopic ultrasonography (EUS) and submucosal saline injection method in the diagnosis of infiltration degree of submucosal carcinoma (sm-ca) . We performed EUS for 55 lesions of sm-ca, and submucosal saline injection method for 19 lesions of sm-ca. The degree of elevation by submucosal saline injection was evaluated for each lesions ; a case in which the lesion was completely elevated was defined as a positive lifting sign, a case in which the lesion was incompletely elevated was defined as a false positive lifting sign, and a case in which the lesion was not elevated was defined as a negative lifting sign.
The results were as follows ;
1) The depth of cancerous invasion was accurately diagnosed by EUS in 76% (42/55 lesions) of sm-ca. Accuracy rate of infiltration degree of sm-ca by EUS was 50% in sm1, 59% in sm2 and 75% in sm3 carcinomas respectively. The infiltration degree of sm-ca mostly correlated with high diagnostic accuracy of EUS. The differentiation between m-sm1 that were generally treated endoscopically and sm2-that were suitable for surgical operation was possible in 89% of sm-ca. Accordingly, EUS was useful in determining the therapeutic method of sm-ca.
2) Lifting sign by submucosal saline injection method were all positive in sm1 carcinomas, and all negative in sm3 carcinomas. In 7 lesions of sm2 carcinomas, lifting sign were positive in 2 lesions, false positive in 2 lesions, and negative in 3 lesions.
It was concluded that EUS and decision of lifting sign by submucosal saline injection method are useful in diagnosing the infiltration degree of sm-ca and in planning therapeutic method.
