Accuracy Estimation for Depth of Esophageal Cancer Invasion between Endoscopic Ultrasonography and Submucosal Esophagography

Yoshito Kuroki, Akira Yamada, Toshihiro Sakakibara, Tetsuro Shimizu, Takashi Sakamoto, Yoshiaki Karaki, Kenji Tazawa, Masao Fujimaki

Second Department of Surgery, Toyama Medical and Pharmaceutical University

We compared the accuracy of estimation of depth of esophageal cancer invasion by endoscopic ultrasonography (EUS) and submucosal esophagography in 20 patients who had received resections. For all patients the over all accuracy rate of EUS and that of submucosal esophagography were the same (80.3%). But in submucosal cancers, the over all accuracy rate of submucosal esophagography was higher than that of EUS (100%, 76.5%, respectively). EUS overdiagnosed all three cases of submucosal cancer, which might be caused by the limited resolving power of the 7.5-MHz echo-probe used in this study and massive invasion of the cancers into the submucosa. On the other hand, in cancers invading to the adventitia (a₁-a₃), the over all accuracy rate of EUS was higher than that of submucosal esophagography (94.1%, 70.6%, respectively). EUS could distinguish between a₁ and mp cancers more sensitively than submucosal esophagography. However, neither examination could diagnose accurately a case with microinvasion into the adventitia. This might be a limitation of the diagnostic power of these methods at this time. Our data suggest that the combined use of EUS and submucosal esophagography would result in more accurate diagnosis of the depth of esophageal cancer invasion.

Key words
diagnosis for depth of invasion of esophageal cancer, endoscopic ultrasonography, submucosal esophagography, esophageal cancer

Reprint requests
Yoshito Kuroki Second Department of Surgery, Toyama Medical and Pharmaceutical University
2630 Sugitani, Toyama City, 930-01 JAPAN

Accepted
April 1, 1992

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