Endoscopic ultrasound in early gastric cancer: Diagnostic accuracy and Tis/T1a lesion over staging risks
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND Accurate T-staging of early gastric cancer (EGC) is critical for selecting the most appropriate treatment strategy. Although the reported diagnostic performance of endoscopic ultrasound (EUS) in determining T stage varies among studies, it continues to serve as an important tool in the pretreatment assessment of EGC. AIM To identify clinicopathological factors that affect the diagnostic accuracy of EUS in EGC, with particular emphasis on mucosal lesions (Tis/T1a). METHODS We included EGC patients who underwent endoscopic resection or gastrectomy. The diagnostic accuracy of EUS was assessed by comparing its T-stage evaluation with the histopathological results of the resected specimens. Additionally, potential risk factors associated with the over staging of Tis/T1a lesions by EUS were investigated. RESULTS A total of 209 patients were included in this study. The overall diagnostic accuracy of EUS for T staging was 74.64%. However, the sensitivity of EUS in identifying Tis/T1a gastric cancers was relatively low at 41.25%. Risk factor analysis showed that younger age (P = 0.035) and the presence of ulceration (P < 0.001) were significantly associated with over staging of Tis/T1a lesions. In multivariate analysis, ulceration remained the only independent predictor of over staging, with an odds ratio of 15.25 (95% confidence interval: 3.23-71.98; P < 0.001). CONCLUSION The accuracy of EUS for staging Tis/T1a early gastric cancer is markedly reduced when gastric ulceration is present. Therefore, EUS-based staging should be interpreted cautiously in patients with ulcer-related lesions.
Authors: Xue-Yan Qiao, Ze-Hua Li, Shi-Yong Lin, Ge Wen
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7128037941