Diagnostic Value Of The EUS-Birads Scoring System For Assessing Malignant Risk Of Lesions In Digestive Tract And Outer Wall Oppression

Objective This study was aimed to establish a new EUS scoring system which was based on the BI-RADS standard, and evaluate its diagnostic value for identifying the benign and malignant lesions in gastrointestinal mucosa or submucosa or outside wall oppression.Methods To establish the EUS-BIRADS scoring system with reference to BI-RADS ultrasound diagnostic criteria.509 cases with path-ological diagnosis of gastrointestinal mucosa or submucosa or outside wall oppression from June 2006 to December 2012 were analyzed retrospectively. We scored for each group of EUS images by reference to EUS-BIRADS scoring system without pathological diagnosis, and then compared scoring with pathological results. Receiver operating curve analysis showed the area under the curve was 0.947. We chose EUS 6.5-Score as the critical value(corresponding Youden Index maximum), and stipulated cases that the score>6-Score tended to be malignant lesions, while the other tended to be non-malignant ones.Pearson’s Chi-Square Test, McNemar Test, sensitivity, specificity, PPV, NPV, Youden index, diagnostic accordance rate, and Kappa value were carried out to assess the diagnostic value of EUS-BIRADS scoring system.Results For the benign and malignant lesions in gastrointestinal mucosa or submucosa or outside wall oppression, EUS-BIRADS scoring system’s sensitivity, specificity, PPV, NPV, Youden index, diagnostic accordance rate, and Kappa value were 85.1%,92.9%,71.2%, 96.8%,0.7795,91.6%,0.7234, respectively. Pearson’s Chi-Square Test (χ2 =269.573, P< 0.001) showed the results of EUS-BIRADS scoring system and pathology were not independent, Pearson’s R=0.728 showed a positive correlation between the two, McNemar Test (P=0.014) showed EUS-BIRADS scoring system could not substitute for pathological diagnosis.Conclusion EUS-BIRADS scoring system which was based on BI-RADS standard had a good reference value for identifying the nature of lesions in digestive tract and the outer wall oppression, and could assist clinicians in predicting the nature of lesions before further examination.