ENDOSCOPIC ULTRASONOGRAPHY IN THE DIAGNOSIS OF AN EARLY ESOPHAGEAL-CARCINOMA

Patients with epithelial or mucosal carcinoma of the esophagus are con sidered to have a much better prognosis than those with submucosal car cinoma, although both lesions are classified as superficial carcinomas of the esophagus. With this in mind, we evaluated the usefulness of e ndoscopic ultrasonography for pre-operatively distinguishing either ep ithelial or mucosal carcinoma from submucosal carcinoma by comparing t he results of endoscopic ultrasonography with the histological finding s established in resected specimens. Between 1987 and 1991, 26 patient s with no pre-operative treatment were confirmed histologically to hav e epithelial (2 cases), mucosal (11 cases) or submucosal (13 cases) ca rcinomas of the esophagus. In 13 patients with epithelial or mucosal c arcinoma, 10 were correctly diagnosed with endoscopic ultrasonography (76.9%), while the remaining 3 were overdiagnosed as being submucosal. In 13 patients with submucosal carcinoma, 12 were correctly diagnosed by endoscopic ultrasonography (92.3%), although another case was over estimated. Including one patient with an advanced carcinoma who was un derdiagnosed by endoscopic ultrasonography as having a submucosal lesi on, the overall accuracy of endoscopic ultrasonography was 81.5% for d iagnosing the depth of invasion of a superficial esophageal carcinoma. The above results show that endoscopic ultrasonography can provide su rgeons with important information in the pre-operative assessment of a superficial esophageal carcinoma.