The Value Of EUS In The Early Upper Gastrointestinal Cancer

Objective To investigate the accuracy and influencing factors of endoscopic ultrasonography(EUS)in determining the invasion depth of the early upper gastrointestinal cancer.Methods A prospective analysis of 108 patients with the early upper gastrointestinal cancer from November 2016 to February 2018 was performed,collecting the data of those who underwent NBI+ME examination simultaneously.The diagnostic results of EUS and NBI+ME were compared with postoperative pathological findings,of which the difference in the accuracy of EUS in determining the invasive depth was analyzed according to tumor location,gross morphology,with or without ulceration and depth of invasion.The rate comparison and univariate analysis were done by the chi-square test,and multivariate analysis was done using the Logistic regression model.Results Among 108 lesions,the accuracy of EUS was 75.92%,including 79.79%in the mucosa and50%in the submucosa.The total miscarriage rate of EUS was 24.07%,including the superlight rate 19.23%and the excessive rate 80.76%.There were statistically significance(P<0.05)between two groups.In 77 cases of all lesions,the accuracy of NBI+ME was85.71%,including 91.55%in the mucosa and 16.67%in submucosa carcinoma,having statistically significance comparing with EUS in the mucosa(P<0.05).The total false rate was 14.29%,while the over-light rate and over-deep rate were similar.There was significant difference in the accuracy of EUS for evaluating the invasion depth among the patients with gross morphology and the depth of invasion(X~2=8.22,5.92,P<0.05),while the accuracy of EUS between different parts and ulcerative lesions was a little significant(X~2=4.00,3.94,P<0.05).The result of multivariate analysis showed that the gross morphology,ulcer and depth of invasion was independent factors affecting the accuracy of EUS in determining the depth(P<0.05).Conclusions The clinical value of EUS in the determining invasive depth of upper gastrointestinal cancer is relatively positive.The accuracy of EUS detecting in the mucosa is higher than the submucosal stage of UGIC,and the factors affecting the accuracy of EUS included gross morphology,ulcer and the depth of invasion.