The factors influencing the accuracy of pre‐operative endoscopic ultrasonography assessment in endoscopic treatments for gastrointestinal tumors

• Published in: Cancer medicine (Malden, MA) MA), 2023-02, Vol.12 (4), p.4321-4331
• Main Authors: Zhao, Yan, Ren, Mudan, Jia, Ai, Zhang, Juan, Wang, Shuying, Zhao, Qian, Cai, Guohong, He, Shuixiang
• Format: Article
• Language: English
• Subjects: Accuracy; Cardia - pathology; Catheters; Colon; Decision making; diagnostic accuracy; Dissection; endoscopic submucosal dissection; endoscopic ultrasonography; Endoscopy; Endosonography; Esophagus; Gastrointestinal Neoplasms - diagnostic imaging; Gastrointestinal Neoplasms - surgery; gastrointestinal superficial tumors; Humans; Lesions; Lymphatic system; Pathology; pre‐operative assessments; Regression analysis; Retrospective Studies; Risk factors; Small intestine; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - surgery; Tumors; Ultrasonic imaging
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.5305

Background This retrospective study aimed to evaluate the factors influencing the accuracy of Endoscopic Ultrasonography (EUS) as a preoperative assessment for gastrointestinal tumors. Methods A total of 261 patients with 264 gastrointestinal tumors were enrolled in the study. The parameters of the gastrointestinal lesions examined under EUS and their pathology were recorded and analyzed. Results The accuracy of EUS for detecting intramucosal lesions and subepithelial lesions (SELs) were 83.6% and 91.4%, respectively. One hundred and ninety‐four (73.5%) lesions originated from the mucous layer, as determined by pre‐operation EUS examinations. The accuracy of EUS in predicting the correct T stage for intramucosal lesions in the gastric region, esophagus, and colorectum was 77%, 71.8%, and 84.6%, respectively. According to the Paris endoscopic classification, the distribution of macroscopic patterns was different between the EUS‐pathology conformity and nonconformity groups (p = 0.018). In the nonconformity group, 48.6% of erosive lesions were classified as 0‐IIc, 0‐IIa + IIc, 0‐IIc + IIa or 0‐III macroscopic patterns compared with 26% patients in the conformity group (p = 0.025). Univariate analyses demonstrated that ulcerative lesions (OR = 7.516, 95% Confidence Interval [CI] 2.574–21.952, p