A new diagnostic method for early gastric cancer: volume measurement by 3-dimensional endoscopic ultrasonography in early gastric cancer and its clinical significance.

摘要

BACKGROUND: The objective of the present study was to measure the volume of early gastric cancer using 3-dimensional endoscopic ultrasonography (3D-EUS) and to ascertain the clinical significance of this new diagnostic method. PATIENTS AND METHODS: The study comprised 100 patients with early gastric cancer who underwent preoperative 3D-EUS followed by surgical resection. The relationships of lymph node metastasis to 10 clinicopathological factors (gender, age, tumor location, ulcer, depth, macroscopic type, tumor histology, lymphatic invasion and venous invasion) and preoperative tumor volume (log tumor volume) as measured by 3D-EUS were determined. RESULTS: Median tumor volume was 414.75 mm3 (range, 7.8-2,683.8 mm3) and median log tumor volume was 2.617 (range, 1.444-3.429). Univariate analyses showed that three factors (lymphatic invasion, p=0.0001; venous invasion, p=0.0216; log tumor volume, p=0.0121) correlated significantly with lymph node metastasis. Multivariate analysis showed only two factors (lymphatic invasion, p=0.011, regression coefficient=0.104; log tumor volume, p=0.020, regression coefficient=30.414) representing independent predictors for lymph node metastasis. CONCLUSION: Tumor volume as measured by 3D-EUS represents an independent risk factor for lymph node metastasis in early gastric cancer. This new method can be used as a reliable diagnostic tool for early gastric cancer.