Diagnostic performance of conventional endoscopy in the identification of submucosal invasion by early gastric cancer: the “non-extension sign” as a ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-05-10

AUTHORS

Takashi Nagahama, Kenshi Yao, Kentaro Imamura, Toshiki Kojima, Kensei Ohtsu, Kenta Chuman, Hiroshi Tanabe, Rino Yamaoka, Akinori Iwashita

ABSTRACT

Background and aimThe ability to differentiate between mucosal (M) or microinvasive submucosal (SM1: depth of less than 500 µm) and invasive submucosal (SM2: depth of 500 µm or more) cancer is paramount when choosing the method of treatment for early gastric cancer (EGC). The “non-extension sign” relates to a localized increase in thickness and rigidity due to massive submucosal invasion by a cancer. The present study sought to assess the ability of conventional endoscopy (CE) to correctly identify SM2 cancer using only the non-extension sign.MethodsThis is a retrospective study based on a prospectively collected database. EGCs had been diagnosed according to invasion depth as M-SM1 or SM2. In terms of the endoscopic diagnostic criterion, lesions positive for the non-extension sign were classified as SM2 cancers, while those negative for the non-extension sign were classified as M-SM1 cancers. Histopathological findings were used as the gold standard.ResultsWe examined a total of 863 lesions from 704 patients, comprising 104 true-positive, 733 true-negative, 9 false-positive, and 17 false-negative lesions. This yielded a sensitivity of 92.0 % (95 % confidence interval (CI), 87.0–97.0 %), a specificity of 97.7 % (95 % CI, 96.7–98.8 %), a positive predictive value of 85.9 % (95 % CI, 79.7–92.1 %), a negative predictive value of 98.8 % (95 % CI, 98.0–99.6 %), and a diagnostic accuracy of 96.9 % (95 % CI, 95.8–98.1 %).ConclusionThe non-extension sign may be useful for accurately determining the suitability of minimally invasive endoscopic treatment. Nevertheless, considering the limitations of retrospective analysis, a further prospective study is warranted to confirm the diagnostic reliability of the non-extension sign. More... »

PAGES

304-313

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10120-016-0612-6

DOI

http://dx.doi.org/10.1007/s10120-016-0612-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1036278170

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27165641


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