New Techniques Accuracy of Endoscopic Ultrasonography in Upper Gastrointestinal Submucosal Lesions: a Prospective Multicenter Study

作者：Thomas Rösch, Barbara Kapfer, Uwe Will, W. Baronius, Michael J. Strobel, Reinhard L. Lorenz, Kurt Ulm · 发表于：Scandinavian Journal of Gastroenterology · 年份：2002 · DOI：10.1080/gas.37.7.856.862 · 被引用次数：208 · 研究领域：Gastrointestinal Tumor Research and Treatment、Gastrointestinal disorders and treatments、Esophageal Cancer Research and Treatment

BACKGROUND: Endoscopic ultrasonography (EUS) is commonly agreed to be the best imaging method for diagnosing and differentiating between submucosal lesions in the gastrointestinal tract. However, most of the current evidence for this derives from retrospective multicenter studies. A prospective multicenter analysis of the performance of EUS in diagnosing submucosal lesions in everyday practice was therefore conducted. METHODS: Over a 2-year period, this study included 150 patients (52% men, mean age 59.8 years) from 23 centers who had a presumptive diagnosis of a submucosal lesion on upper gastrointestinal endoscopy. The patients' symptoms and EUS results were recorded. Endoscopic and endosonographic findings regarding lesion size, layer of origin, and the presumptive diagnosis (benign or malignant) were recorded. The reference methods used were surgery, biopsy, other imaging tests, and a follow-up period of 6 months. RESULTS: Of the 150 patients, 102 had an intramural lesion (84 tumors, 18 other lesions such as cysts, aberrant pancreas, etc.), and 48 had an extraluminal compression--in most cases (n = 35) by normal organs or structures. For differentiating between a submucosal and an extraluminal compression, the sensitivity and specificity of endoscopy were 87% and 29%, whereas those of EUS were 92% and 100%. However, the sensitivity and specificity of EUS for differentiating between malignant and benign submucosal tumors were only 64% and 80%, respectively. CONCLUSIONS: Th...