Superficial esophageal carcinoma: evaluation by endoscopic ultrasonography

The aim of this study was to evaluate the usefulness of endoscopic ultrasonography (EUS) in the staging of superficial esophageal carcinoma (SEC).

We examined the histopathologic findings of 28 patients with SEC which was confirmed in the postoperative histologic evaluation. The EUS results preoperatively estimated were compared with them.

There were nine patients with mucosal carcinoma (two intraepithelial carcinomas and seven carcinomas limited to the mucosal layer) and 19 patients with submucosal carcinoma. The mucosal carcinomas revealed no lymph node metastasis or vessel permeation, whereas the submucosal carcinomas revealed lymph node metastasis (71%) and vessel permeation (lymphatic, 58%, vascular, 21%). The accuracy rates of depth of invasion by EUS were mucosa, 67% (6/9); submucosa, 79% (15/19); and total, 75% (21/28). EUS could not detect microinvasion to the submucosa. The overall accuracy rate of EUS in the evaluation of periesophagogastric lymph node metastasis was 72%: sensitivity 58% and specificity 85%.

It has been clinically proved important to differentiate mucosal carcinoma from submucosal carcinoma in the staging of SEC, and EUS is recommended in differentiating between them.