Endoscopic ultrasonography versus Helical computed tomography in preoperative TNM staging of gastric cancer

Objective: Endoscopic ultrasonography and helical computed tomography are very common examination in gastric cancer. This study was going to to evaluate the accuracy of endoscopic ultrasonography and helical computed tomography in preoperative TNM staging of gastric cancer.

Methods: The patients were collected from Union Hospital of Huazhong Science and Technology University from May 2008 to July 2010. 162 gastric cancer patients which were diagnosed by pathology performed endoscopic ultrasonography. The age were from 19 to 81 years old, average age was 46. Among them 77 cases were performed helical computed tomography, 81 cases accepted surgery. 39 patients performed both endoscopic ultrasonography and helical computed tomography before operation. 2010 NCCN gasric cancer TNM staging was used.

Results: The T-staging accuracy of endoscopic ultrasonography (89.7%) was significant higher than the accuracy of helical computed tomography (79.5%)(P<0.05), The accuracy of endoscopic ultrasonography in T1, T2, T3 and T4 was 50%, 100%, 100% and 93.1%, respectively. N-staging accuracy of endoscopic ultrasonography (63.0%) was similar with helical computed tomography (56.4%). N1-staging accuracy in endoscopic ultrasonography (85.7%) was significant higher than helical computed tomography (57.1%) (P<0.05), but N3-staging accuracy in endoscopic ultrasonography (25.1%) was significant lower than helical computed tomography (44.4%)(p<0.05).

Conclusion: The T-staging accuracy of endoscopic ultrasonography was higher than helical computed tomography, N3-staging accuracy in helical computed tomography was higher than endoscopic ultrasonography. In clinical work, we could combine endoscopic ultrasonography and helical computed tomography in preoperative evaluate to get more accurate result.