Diagnostic value of endoscopic ultrasound combined with depth-predicting score in early-stage adenocarcinoma of the esophagogastric junction
NIU Sensen
ZHU Zhen
JIN Shu
CHEN Yuangan
ZHOU Yubao
Abstract：Objective To evaluate the diagnostic value of endoscopic ultrasonography(EUS)combined with the depth-predicting score(DPS)for assessing invasion depth in early-stage adenocarcinoma of the esophagogastric junction(AEG).Methods A retrospective analysis was conducted on the clinical data of 89 patients with early AEG who were treated between January 2018 and January 2024.The preoperative evaluation results of EUS and DPS for early AEG were analyzed.Diagnostic performance of EUS and DPS-individually and in combination-was assessed by comparison with postoperative pathological findings(gold standard)to evaluate their value in determining tumor invasion depth.Results Among 89 early AEG patients,77.5%(69/89)underwent endoscopic submucosal dissection and 22.5%(20/89)underwent surgical treatment.The DPS ranged from 1 to 6 points,with 29.2%(26/89)scoring≥3 points and 70.8%(63/89)scoring<3 points.EUS examination identified 64.0%(57/89)of lesions as intramucosal carcinomas and 36.0%(32/89)as submucosal carcinomas.Final pathological staging confirmed 75.3%(67/89)as intramucosal carcinomas and 24.7%(22/89)as submucosal carcinomas.The diagnostic accuracy of using EUS alone was 71.9%(64/89)with sensitivity of 65.2%(15/23)and specificity of 74.2%(49/66).The accuracy of using DPS alone was 74.2%(66/89)with sensitivity of 56.5%(13/23)and specificity of 80.3%(53/66).The combined application of the two methods can significantly improve diagnostic efficiency,with an accuracy of 88.8%(79/89),sensitivity increased to 87.0%(20/23),and specificity increased to 89.4%(59/66).Kappa consistency analysis showed that the consistency level of combined diagnosis(0.610)was significantly better than using EUS alone(0.320)or DPS alone(0.412).Conclusion The EUS-DPS integrated protocol synergizes EUS's layered-structure visualization with DPS's quantitative scoring,offering superior assessment of early AEG invasion depth and optimized surgical decision-making.
Keywords：Early-stage adenocarcinoma of the esphagogastric junctionEndoscopic ultrasonographyDepth-predicting scoreEndoscopic submucosal dissection
Publication Date：2025-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 389-393 )