Role of Ultrasonography in Determining Treatment for m and sm Cancer of GI Tract -Depiction of the Muscularis Mucosa-

Yoko Murata, Shigeru Suzuki, Shigeki Sugiyama, Kazuhiko Hayashi, Kiyotaka Yamamoto, Tsuyoshi Sasagawa, Yoichi Kitamura, Mamoru Suzuki, Hiroko Ide, Akiyoshi Yamada, Hirotaka Suzuki, Fujio Hanyu

Department of Gastroendoscopy, Department of Surgery, Tokyo Women's Medical College

The aim of this study was to determine the accuracy of high frequency ultrasonography in distinguishing between mucosal cancer and submucosal cancer by depicting the muscularis mucosa. A sonoprobe system (15 or 20 MHz, linear type, Fujinon Co.) was employed. Of 70 patients with superficial cancer who were examined, 26 underwent mucosal resection under endoscopy, while 44 underwent surgery, resected specimen compared with ultrasonographic findings. In esophageal cancer, epithelial cancer was correctly diagnosed in 100%, mucosal cancer 56%, submucosal cancer 100%, an overall accuracy rate of 82%. In gastric cancer, mucosal cancer was accurately diagnosed in 58%, submucosal cancer in 88%. In cases of cancer concomitant with ulcer or ulcer scar, it was difficult to distinguish US findings of muscularis mucosa destroyed by cancer from those of ulcer scar. Therefore, accuracy was lower (17%) in cases with cancer concomitant ulcer than in cases without scar (93%). In colon cancer, mucosal cancer was correctly diagnosed in 93% and submucsal cancer in 100%, an overall accuracy rate of 95%. Thus high frequency ultrasonography provides precise differential diagnosis between mucosal cancer and submucosal cancer, however ulcer scar may make the diagnosis difficult.

Key words
endoscopic ultrasonography, diagnosis of the depth of cancer invasion in GI tract, superficial cancer in GI tract

Reprint requests
Yoko Murata Department of Gastroendoscopy, Tokyo Women's Medical College
8-1 Kawadacho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
June 14, 1993

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