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Clinicopathologic factors influence accurate endosonographic assessment for early gastric cancer

 Jie-Hyun Kim  ;  Kee Sup Song  ;  Jae Bock Chung  ;  Si Young Song  ;  Jae Hee Cheon  ;  Yong Chan Lee  ;  Young Hoon Youn 
 GASTROINTESTINAL ENDOSCOPY, Vol.66(5) : 901-908, 2007 
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Issue Date
Diagnostic Errors ; Endosonography/standards* ; Humans ; Lymphatic Metastasis/diagnosis ; Neoplasm Invasiveness/diagnosis ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/pathology
BACKGROUND AND OBJECTIVE: EUS has become a valuable tool for the selection of patients who are suitable for EMR of early gastric cancer (EGC). The aim of this study was to evaluate the various clinicopathologic factors affecting the diagnostic accuracy of EUS in EGC. DESIGN AND SETTING: A retrospective, single-center study. PATIENTS: A total of 206 patients suspected of EGC endoscopically who underwent EUS examination and curative treatment for EGC at Severance Hospital, Seoul, Korea, from October 2001 to May 2005 were included. INTERVENTIONS: We reviewed the medical records of 206 patients and compared preoperative EUS staging with final histopathologic staging of the resected specimen according to the clinicopathologic parameters. MAIN OUTCOME MEASUREMENTS AND RESULTS: The diagnostic accuracy of EUS for predicting tumor invasion depth was significantly affected by the histopathologic differentiation and the size of tumor. The differentiated cell types were associated with higher diagnostic accuracy in predicting the tumor invasion. Lesions located in the mid one third of the stomach larger than 3 cm had significantly higher probability of overstaging. Poorly differentiated histologic diagnosis had a significantly higher probability of understaging. There was no significant factor associated with the endosonographic prediction of lymph node metastasis. CONCLUSIONS: EGC with undifferentiated histopathologic features or large tumor size is more frequently associated with an incorrect diagnosis in tumor invasion depth by EUS. EGC with a size larger than 3 cm and poorly differentiated histologic diagnosis should be cautiously considered in the decision on treatment modality by pretreatment EUS staging.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Song, Kee Sup(송기섭)
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Chung, Jae Bock(정재복)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
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