Comparison of diagnostic accuracy between linear EUS and miniprobe EUS for submucosal invasion in suspected cases of early gastric cancer

ABSTRACT

Objective: this study assessed the accuracy of linear endoscopic ultrasound (EUS) to diagnose submucosal (SM)invasion and compared linear EUS with miniprobe EUS insuspected early gastric cancer (EGC) patients.Methods: patients diagnosed with biopsy-verified suspected EGC were analyzed retrospectively. All cases wereexamined by linear EUS or miniprobe EUS for preoperativediagnosis of invasion depth and underwent endoscopic orsurgical treatment for radical resection. The invasion depthevaluated by EUS and pathology were categorized as noinvasion of SM and invasion of SM or deeper. The diagnosis of EUS was compared with postoperative pathologyresults.Results: a total of 105 patients were included in the finalanalysis. The overall prediction accuracy of linear EUS(n = 57) for SM invasion in suspected EGC was higherthan that of miniprobe EUS (n = 48), although no statistically significant differences were noted (82.5 % vs 72.9 %,p = 0.344). The negative predictive value (NPV) of linear EUSwas significantly higher than that of miniprobe EUS (100 %vs 82.8 %, p = 0.037). The binary logistic regression analysis showed that tumor size (p = 0.036), the presence of ulceration (p < 0.001) and EUS type (p = 0.027) were independentrisk factors for the diagnosis of SM invasion by EUS. Thearea under the receiver operating curve (ROC) was 0.889and 0.719 for linear and miniprobe EUS, respectively.Conclusion: linear EUS diagnosed suspected EGC for SMinvasion with a higher accuracy than miniprobe EUS. Inaddition, large and ulcerative lesions may lead to overestimation. (AU)