Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoscopic ultrasonography.

BACKGROUND In diagnosing superficial esophageal carcinoma, it is necessary to differentiate mucosal carcinoma from submucosal carcinoma because mucosal carcinoma has a good prognosis and local treatment is likely to be successful. We evaluated an ultrasound probe and endoscopic ultrasonography (EUS) in the staging of superficial esophageal carcinoma. METHODS From October 1992 to September 1994, 22 patients with 25 lesions (7 mucosal carcinomas, 18 submucosal carcinomas) were examined preoperatively with both the probe and EUS. The ultrasound findings were compared with histologic findings in all cases. RESULTS The accuracy rates of the depth of invasion by the ultrasound probe were 86% (6 to 7) for mucosal carcinoma and 94% (17 to 18) for submucosal carcinoma, total 92% (23 to 25); by EUS 71% (5 to 7) for mucosal carcinoma and 78% (14 to 18) for submucosal carcinoma, total 76% (19 to 25). In the evaluation of lymph node metastasis, the overall accuracy was 56% by the ultrasound probe (sensitivity 25% and specificity 80%) and 67% by EUS (sensitivity 50% and specificity 80%). CONCLUSIONS The ultrasound probe was more convenient to use and more accurate than EUS in the evaluation of the depth of invasion of superficial esophageal carcinoma.

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