Limitations of endoscopic ultrasonography in the diagnosis of esophageal submucosal tumor

Abstract

Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS) for esophageal submucosal tumor (SMT). Methods Clinical data of 388 patients with esophageal SMT, who underwent EUS and endoscopic treatment in Tianjin Medical University General Hospital were collected from May 2010 to September 2016. The golden standard for the origin of esophageal SMT was the diagnosis during endoscopic treatment, and the golden standard of pathological type was the combination of postoperative pathological and immunohistochemical findings. The diagnostic accuracy of EUS for esophageal SMT was evaluated. Results The conventional endoscopy revealed that 31.70% (123/388) and 43.81% (170/388) esophageal SMTs were located in the middle and lower segments of esophagus, respectively. The diagnostic consistency of EUS for the origin of lesion was 71.51% (251/351), while the diagnostic consistency of EUS for lesion originated from the muscularis mucosae, submucosa and muscularis propria layer was 92.90% (170/183), 34.38% (11/32), and 51.47% (70/136), respectively. The diagnostic consistency of EUS for the type of lesion was 81.00% (260/321), while the diagnostic consistency of leiomyoma, esophageal cyst, and lipoma were 88.42% (252/285), 14.81% (4/27), and 80.00% (4/5), respectively. Conclusion EUS can preliminarily diagnose the origin and pathological type of esophageal SMT, but there are limitations on the diagnosis of uncommon lesions, which need combination of pathological and immunohistochemical findings. Key words: Endoscopic ultrasonography; Esophageal neoplasms, submucosal; Diagnosis; Accordance rate