Endoscopic ultrasound in early gastric cancer: Diagnostic accuracy and Tis/T1a lesion over staging risks

Table 1 The characteristics of 209 patients with early gastric cancer, n (%)

Characteristics
Age, year, median (IQR)	58.00 (50.00-66.00)
BMI, kg/m2, median (IQR)	22.01 (19.88-24.06)
Size, cm, median (IQR)	2.00 (1.50-3.00)
Male	119 (56.94)
Ulcer
Absent	54 (25.84)
Present	155 (74.16)
Location
Upper	26 (12.56)
Middle	65 (31.40)
Lower	116 (56.04)
Differentiation
Well/moderate	71 (33.97)
Poorly	138 (66.03)
Depth of invasion
Tis/T1a	80 (38.28)
T1b	129 (61.72)
Lymph node metastasis	51 (24.40)
Lymph vascular invasion	21 (10.05)
Perineural invasion	4 (1.91)

IQR: Interquartile range; BMI: Body mass index.

Table 2 Diagnostic value of endoscopic ultrasonography for T staging early gastric cancer

EUS diagnosis	Histology diagnosis		Total
	Tis/T1a	T1b
Tis/T1a	33	6	39
T1b or deeper	47	123	170
Total	80	129	209

Tis/T1a sensitivity = 33/(33 + 47) × 100% = 41.25%. Tis/T1a specificity = 123/(6 + 123) × 100% = 95.35%. Tis/T1a positive predictive value = 33/(33 + 6) × 100% = 84.62%. Tis/T1a negative predictive value = 123/(47 + 123) × 100% = 72.35%. Overall accuracy = (33 + 123)/(33 + 6 + 47 + 123) × 100% = 74.64%. EUS: Endoscopic ultrasound.

Table 3 Factors associated with overestimation of Tis/T1a early gastric cancer by endoscopic ultrasonography, n (%)

	Accuracy (n = 33)	Overestimation (n = 47)	P value
Age, year
< 50	6 (18.18)	19 (40.43)	0.035
≥ 50	27 (81.82)	28 (59.57)
Gender
Male	13 (39.39)	24 (51.06)	0.365
Female	20 (60.61)	23 (48.94)
BMI, kg/m2
< 24	23 (69.70)	38 (80.85)	0.249
≥ 24	10 (30.30)	9 (19.15)
Size, cm
< 3	22 (66.67)	31 (65.96)	0.947
≥ 3	11 (33.33)	16 (34.04)
Ulcer finding
Absent	15 (45.45)	5 (10.64)	< 0.001
Present	18 (55.55)	42 (89.36)
Location
Upper	3 (9.09)	3 (6.38)	0.626
Middle	12 (36.36)	13 (27.66)
Lower	8 (24.24)	31 (65.96)
Differentiation
Well/moderate	14 (42.42)	21 (44.68)	1.000
Poorly	19 (57.58)	26 (55.31)

BMI: Body mass index.

Table 4 Univariate and multivariate analysis for factors influencing overestimation of Tis/T1a early gastric cancer

	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Age, year
≥ 50	1.00		1.00
< 50	3.05 (1.06-8.81)	0.039	6.24 (1.31-29.63)	0.021
Gender
Male	1.00		1.00
Female	0.62 (0.25-1.54)	0.304	0.37 (0.11-1.17)	0.090
BMI, kg/m2
≥ 24	1.00		1.00
< 24	1.84 (0.65-5.19)	0.252	4.38 (1.06-18.18)	0.042
Size, cm
< 3	1.00		1.00
≥ 3	1.03 (0.40-2.65)	0.947	1.21 (0.35-4.19)	0.759
Ulcer
Absent	1.00		1.00
Present	7.00 (2.21-22.17)	< 0.001	15.25 (3.23-71.98)	< 0.001
Location
Upper	1.00		1.00
Middle	1.08 (0.18-6.44)	0.745	0.36 (0.03-4.63)	0.175
Lower	1.72 (0.31-9.45)	0.354	1.48 (0.16-13.38)	0.193
Differentiation
Well/moderate	1.00		1.00
Poorly	0.91 (0.37-2.24)	0.841	0.32 (0.08-1.24)	0.100

BMI: Body mass index; OR: Odds ratio; CI: Confidence interval.