A simple method for diagnosing gallbladder malignant tumors with subserosa invasion by endoscopic ultrasonography

BMC Cancer

Yuko Hashimoto¹  Yuka Oka¹  Takuto Hikichi²  Hiroyuki Asama³  Ryoichiro Kobashi³  Tadayuki Takagi³  Hiromasa Ohira³  Mitsuru Sugimoto³  Hiroki Irie³  Mika Takasumi³  Yuki Sato³  Rei Suzuki³  Naoki Konno³  Minami Hashimoto⁴  Tsunetaka Kato⁴  Jun Nakamura⁴  Shigeru Marubashi⁵ 

[1] Department of Diagnostic Pathology, School of Medicine, Fukushima Medical University, Fukushima, Japan;Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan;Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima, Japan;Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima, Japan;Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan;Department of Hepato-Biliary-Pancreatic and Transplant Surgery, School of Medicine, Fukushima Medical University, Fukushima, Japan;

关键词: EUS;    Gallbladder malignant tumor;    Depth;    Subserosa invasion;   

DOI  :  10.1186/s12885-021-08017-x

来源: Springer

【 摘 要 】

BackgroundIf the depth of gallbladder malignant tumor (GBMT) invasion is deeper than the subserosa (ss), cholecystectomy is insufficient. In past reports that used endoscopic ultrasonography (EUS) to diagnose the depth of tumor invasion, it was difficult to diagnose GMBT invasion in the ss without a narrow or disrupted lateral hyperechoic layer (LHEL). Therefore, we developed a simple preoperative method to diagnose GBMTs with ss invasion.MethodsForty-nine GBMT patients who underwent both EUS and surgery were enrolled: 15 patients whose tumors invaded the mucosa (m) or muscularis propria (mp) were classified as the “shallow group”, and 34 patients whose tumors invaded the ss were classified as the “deep group”. The EUS findings were compared between the two groups.ResultsAn irregular (narrow or thickened) LHEL was significantly more frequently observed on EUS in the deep group than in the shallow group. The diagnosis of ss invasion based on an irregular LHEL had the highest sensitivity and accuracy among the EUS imaging parameters (sensitivity 97.1% (33/34), specificity 86.7% (13/15), accuracy 93.8% (46/49)). When the deep group was limited to patients with a tumor depth of ss, the results were similar. When an irregular LHEL was used, the diagnostic accuracy of GBMTs with ss invasion was not significantly different between EUS specialists and beginners.ConclusionsThe observation of an irregular (thickened or narrow) LHEL observed on EUS could be a reliable and simple method of diagnosing GBMTs with ss invasion and could contribute to choosing an appropriate surgical method.

【 授权许可】

CC BY