title: Diagnostic ability of high-frequency ultrasound probe sonography in staging early gastric cancer, especially for submucosal invasion.
abstract: BACKGROUND
  Advances in gastrointestinal endoscopy have resulted in endoscopic mucosal resection becoming the main therapy for many early gastric cancers confined to the mucosa and, in some cases, of minimal submucosal invasion. Thus, preoperative determination of the depth of the cancer is important. We compared the results of high-frequency ultrasound probe sonography with those of histologic study to clarify the usefulness of identifying of submucosal invasion and determining the depth of early gastric cancer.
  
  
  METHODS
  Subjects were 295 patients diagnosed with early gastric cancer who had undergone endoscopic mucosal or surgical resection. High-frequency ultrasound probe sonographic findings were compared with histologic findings.
  
  
  RESULTS
  The muscularis mucosae was visualized in 63% of cases of early gastric cancer. By construction on receiver operator characteristics curve, we determined that submucosal invasive cancer could be diagnosed by high-frequency ultrasound probe sonography to a depth of about 600 microm. There was no case in which invasion deeper than 1000 microm was diagnosed as a hypoechoic area limited to the mucosal layer or a fan-shaped hypoechoic area in the submucosal layer. The depth of early gastric cancer was accurately determined in 90% of cases.
  
  
  CONCLUSIONS
  High-frequency ultrasound probe is a useful tool for accurately determining the depth of invasion of early gastric cancer when its limitations are understood.
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yoshida
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Kunihiro
authors.forename: Y
authors.initials: Y
authors.lastname: Mitsuoka
authors.forename: M
authors.initials: M
authors.lastname: Hara
authors.forename: Y
authors.initials: Y
authors.lastname: Kitadai
authors.forename: J
authors.initials: J
authors.lastname: Hata
authors.forename: M
authors.initials: M
authors.lastname: Yoshihara
authors.forename: K
authors.initials: K
authors.lastname: Haruma
authors.forename: N
authors.initials: N
authors.lastname: Hayakawa
authors.forename: K
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography