The usefulness of endoscopic ultrasonography in differentiation between benign and malignant gastric ulcer
Background/Aim. Gastric ulcer may be benign or malignant. In terms of therapy and patient’s prognosis early detection of malignancy is very important. The aim of this study was to assess the usefulness of endoscopic ultrasound (EUS) in differentiation between benign and malignant gastric ul...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Military Health Department, Ministry of Defance, Serbia
2016-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500046R.pdf |
| Summary: | Background/Aim. Gastric ulcer may be benign or malignant. In terms of therapy
and patient’s prognosis early detection of malignancy is very important. The
aim of this study was to assess the usefulness of endoscopic ultrasound (EUS)
in differentiation between benign and malignant gastric ulcer. Methods. A
prospective study included 20 consecutive adult patients with malignant
gastric ulceration and 20 consecutive adult patients with benign gastric
ulceration. All the patients underwent EUS. A total of 6 parameters were
analyzed: ulcer width, ulcer depth, the thickness of the gastric wall along
the edge of ulceration (T0), the thickness of the gastric wall 2 cm from the
edge of ulceration (T2), loss of layering structure of the gastric wall, and
the presence of regional lymph nodes. EUS criteria for malignancy and a
point-score of malignancy were defined. The critical value of total
point-score was also calculated showing the best reliability parameters.
Results. There are 4 criteria for malignancy of gastric ulceration: T0 > 10
mm, T2 > 5 mm, EUS visualization of at least one lymph node, loss of layering
structure of the gastric wall. Furthermore, T2 > 5 mm was the only EUS
independent predictor of ulcer malignancy. The total point score of ≥ 4 was
the cut-off pointscore value which gave the best reliability parameters in
the assessment of malignant ulcers: sensitivity of 70%, specificity of 95%,
positive predictive value of 93.3%, negative predictive value of 76% and
accuracy of 82.5%. Conclusion. According to the results obtained in this
study, we can conclude that EUS is usefull in differentiation between benign
and malignant gastric ulcer. |
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| ISSN: | 0042-8450 2406-0720 |