Staging of Gastric and Esophageal Carcinoma by Means of Endoscopic Ultrasonography

Abstract

Strohm WD, Classen M. Staging of gastric and esophageal carcinoma by means of endoscopic ultrasonography. Scand J Gastroenterol 1987, 22(suppl 133), 17-21Endoscopic ultrasonography (EUS) enables an exact evaluation of the wall of the upper GI tract. The esophageal and the gastric wall give a typical five-layer image, presumably corresponding to the mucosa, submucosa, tunica muscularis propria, and serosa. Gastric ulcers are often accompanied by a thickening of the gastric wall (10.4 +. 3.7 mm) compared with the normal gastric wall (3.7 2 0.6mm; p < 0.001).Malignant tumors show an irregular structure with infiltration into the wall and into neighboring tissues with destruction of the G I wall. Para-esophageal and para-gastric lymph node metastases can be visualized. Benign esophageal and gastric tumors are sharply delineated from the surrounding tissue. The results suggest that, by EUS, it is possible to differentiate carcinomas from benign submucosal tumors of the upper GI tract and to judge the extent of the infiltration and the stage of the malignant process.

Endoscopic Ultrasonography in the Assessment of Invasive Gastric Cancer

“…EUS is a combination of ultrasonography and endoscopy which has made it easier to visualize the wall structure of the gastrointestinal tract (1,2). The normal gastric wall is usually visualized as a five-layer structure, each layer corresponding to an anatomic layer (7).…”

“…In comparison with the customary endoscopic and radiologic techniques, endoscopic ultrasonography (EUS) provides us with a new tool to assess the upper gastrointestinal tract, which has the potential to reach regions previously inaccessible (1,2). EUS has been found useful in assessing the depth of invasion of gastric cancer, an important factor in the prognosis of patients (3,4).…”