Staging of Gastric and Esophageal Carcinoma by Means of Endoscopic Ultrasonography

Abstract

Endoscopic ultrasonography (EUS) enables an exact evaluation of the wall of the upper GI tract. The esophageal and the gastric wall give a typical five-layer image, presumably corresponding to the mucosa, submucosa, tunica muscularis propria, and serosa. Gastric ulcers are often accompanied by a thickening of the gastric wall (10.4 ± 3.7 mm) compared with the normal gastric wall (3.7 2 0.6 mm; p < 0.001). Malignant tumors show an irregular structure with infiltration into the wall and into neighboring tissues with destruction of the GI wall. Para-esophageal and para-gastric lymph node metastases can be visualized. Benign esophageal and gastric tumors are sharply delineated from the surrounding tissue. The results suggest that, by EUS, it is possible to differentiate carcinomas from benign submucosal tumors of the upper GI tract and to judge the extent of the infiltration and the stage of the malignant process.

Key Words:

• Endoscopic ultrasonography
• esophageal tumors
• gastric tumors