Study On The Diagnostic Value Of Ultrasonic Endoscopy In Early Gastric Cancer And Precancerous Lesions

Objective:Endoscopic ultrasonography is to determine the early gastric cancer line of endoscopic submucosal dissection surgery indications and reliable method,is the important indexes of the early gastric cancer surgery way,the purpose of this paper is to through the retrospective analysis of endoscopic ultrasonography in the diagnosis of early gastric cancer and precancerous lesions invaded depth value,and is not consistent to the diagnosis of cases do a simple analysis,with a view to guiding clinical work.Methods:A retrospective analysis was performed on the clinicopathological data who were diagnosed with early-stage gastric cancer and underwent ESD treatment and EUS examination from November 20,2018 to November 20,2021 in the First Hospital of Shanxi Medical University.According to the depth of lesion invasion determined by EUS,the lesions were divided into mucosal layer,mucosal muscle layer,and submucosal layer.Because statistics found that the vast majority of EUS in the diagnosis of preoperative did not distinguish between muscularis mucosa and mucosa,so this research will muscularis mucosa and mucosa unified into the mucous layer group,another group of divided into submucosa group,and the gold standard for judging by postoperative pathological results,evaluate endoscopic ultrasonography for early gastric cancer and precancerous lesions consistency and accuracy of the invasion depth of judgment,The cases with inconsistent preoperative and postoperative diagnosis were summarized and simply analyzed.Results:Based on the analysis of clinical data of 85 patients(63 males(74.12%),22 females(25.88%),average age of 61 years old,24 cases of foci distributed in cardia,32 cases in gastric antrum,8 cases in gastric Angle and 21 cases in gastric body),There were 68 cases of preoperatively diagnosed lesions originating in mucosal layer(67 cases were diagnosed in mucosal layer and 1 case was diagnosed in submucosal layer)by EUS(17 cases were diagnosed in submucosal layer and 6 cases in submucosal layer and 11 cases in submucosal layer).Compared with postoperative pathological diagnosis,preoperative EUS diagnosis showed good accuracy(accuracy 91.76%)and good consistency(consistency K=0.71).Conclusion:Through this study,endoscopic ultrasonography(EUS)has good diagnostic value,high accuracy and good consistency in early gastric cancer(ECG).Therefore,in addition to ordinary white light,magnification endoscopy,NBI model evaluation,pigment gastroscopy and pathological confirmation by biopsy,ultrasound endoscopy is also crucial before ESD of early gastric cancer.Caution should be exercised especially at the cardia/fundus site,where diagnostic mismatches occur more frequently than at other sites.Accurate preoperative evaluation of the lesions and the final selection of appropriate treatment plan can greatly save medical resources and bring maximum benefits to patients.