World journal of gastroenterology · 2026
Endoscopic ultrasound in early gastric cancer: Diagnostic accuracy and Tis/T1a lesion over staging risks.
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Qiao Xue-Yan, Li Ze-Hua, Lin Shi-Yong, Wen Ge
Аннотация
BACKGROUND: Accurate T-staging of early gastric cancer (EGC) is critical for selecting the most appropriate treatment strategy. Although the reported diagnostic performance of endoscopic ultrasound (EUS) in determining T stage varies among studies, it continues to serve as an important tool in the pretreatment assessment of EGC.
AIM: To identify clinicopathological factors that affect the diagnostic accuracy of EUS in EGC, with particular emphasis on mucosal lesions (Tis/T1a).
METHODS: We included EGC patients who underwent endoscopic resection or gastrectomy. The diagnostic accuracy of EUS was assessed by comparing its T-stage evaluation with the histopathological results of the resected specimens. Additionally, potential risk factors associated with the over staging of Tis/T1a lesions by EUS were investigated.
RESULTS: A total of 209 patients were included in this study. The overall diagnostic accuracy of EUS for T staging was 74.64%. However, the sensitivity of EUS in identifying Tis/T1a gastric cancers was relatively low at 41.25%. Risk factor analysis showed that younger age (P = 0.035) and the presence of ulceration (P < 0.001) were significantly associated with over staging of Tis/T1a lesions. In multivariate analysis, ulceration remained the only independent predictor of over staging, with an odds ratio of 15.25 (95% confidence interval: 3.23-71.98; P < 0.001).
CONCLUSION: The accuracy of EUS for staging Tis/T1a early gastric cancer is markedly reduced when gastric ulceration is present. Therefore, EUS-based staging should be interpreted cautiously in patients with ulcer-related lesions.
AIM: To identify clinicopathological factors that affect the diagnostic accuracy of EUS in EGC, with particular emphasis on mucosal lesions (Tis/T1a).
METHODS: We included EGC patients who underwent endoscopic resection or gastrectomy. The diagnostic accuracy of EUS was assessed by comparing its T-stage evaluation with the histopathological results of the resected specimens. Additionally, potential risk factors associated with the over staging of Tis/T1a lesions by EUS were investigated.
RESULTS: A total of 209 patients were included in this study. The overall diagnostic accuracy of EUS for T staging was 74.64%. However, the sensitivity of EUS in identifying Tis/T1a gastric cancers was relatively low at 41.25%. Risk factor analysis showed that younger age (P = 0.035) and the presence of ulceration (P < 0.001) were significantly associated with over staging of Tis/T1a lesions. In multivariate analysis, ulceration remained the only independent predictor of over staging, with an odds ratio of 15.25 (95% confidence interval: 3.23-71.98; P < 0.001).
CONCLUSION: The accuracy of EUS for staging Tis/T1a early gastric cancer is markedly reduced when gastric ulceration is present. Therefore, EUS-based staging should be interpreted cautiously in patients with ulcer-related lesions.