2022,
BMC Cancer.
DOI:
10.1186/s12885-022-09870-0
A potential decision-making algorithm based on endoscopic ultrasound for staging early gastric cancer: a retrospective study
Yan Yan
, Zhonghua Ma
, Xin Ji
, Jiawei Liu
, Ke Ji
, Shijie Li
, Qi Wu
Abstract:
Abstract
Background
Clinical staging of gastric cancer (GC) before treatment is essential. Endoscopic ultrasound (EUS) is a recommended staging tool, but its efficacy remains controversial. Our previous prospective study evaluated the potential value of EUS for T staging and presented discrepancies. In this study, we aimed to evaluate the efficacy of EUS in T staging by comparing it with pathological staging. We analyze the factors that can potentially affect accuracy to identify suitable subgroups for EUS staging.
Methods
Data from a total of 1763 consecutive patients with GC from January 2015 to December 2017 were analyzed. Results from EUS and pathological T staging were compared. The factors that might affect EUS’s accuracy were analyzed.
Results
The sensitivity, specificity, positive predictive value, and negative predictive value of EUS in patients with early GC were 62.08%, 96.13%, 90.94%, and 80.21%, respectively. The accuracy rates of uT1, uT2–uT4, and uT3–uT4 were 90.94%, 79.02%, and 78.39%, respectively. In multivariate analysis, underestimation was more likely to be observed in patients with tumors located in the middle or upper third of the stomach. Overestimation was more likely to be observed in patients with tumors located in the lower third or those without ulcer. Other factors affecting accuracy included ulcer, differentiation, larger size and undergoing surgery.
Conclusion
Our findings highlight the role of EUS in determining the T staging of GC. Overestimation and underestimation in T-staging were significantly associated with the tumor location in early GC, and a decision-making algorithm was proposed for clinical practice in early cancers based on these findings.
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2023-03-16 18:02:00
龙海晨:
#paper Yan Y, Ma Z, Ji X, Liu J, Ji K, Li S, Wu Q. A potential decision-making algorithm based on endoscopic ultrasound for staging early gastric cancer: a retrospective study. BMC Cancer. 2022 Jul 13;22(1):761. doi: 10.1186/s12885-022-09870-0. PMID: 35831843; PMCID: PMC9281103. 文章是研究内镜超声分析所得到的图像与胃癌早期分型间的关系，通过研究影像中肿瘤位置，是否胃溃疡，分化程度，肿瘤大小等指标，建立相关的算法，计算肿瘤分期，确定相应的治疗方案。为早期胃癌诊断治疗提供了一种决策算法。