Abstract
ObjectiveTo determine the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of upper gastrointestinal submucosal lesions (SMLs).MethodsThis was a retrospective study involving patients diagnosed with SMLs using EUS and confirmed by histopathology from November 2014 to December 2020 at The Third Xiangya Hospital of Central South University.ResultsA total of 231 patients with SMLs were examined by EUS. Histologically, 107 lesions were stromal tumors, and 75 lesions were leiomyomas. Stromal tumors were mainly located in the stomach (89.7%), and leiomyomas were predominantly seen in the esophagus (69.3%). The diagnostic accuracy of EUS for stromal tumors and leiomyomas was 80.4% and 68.0%, respectively. The diagnostic accuracy was highest for lesions located in the muscularis mucosa. The mean diameter of stromal tumors measured using EUS was significantly larger than that of leiomyomas (21.89 mm vs. 12.35 mm, p < 0.001). Stromal tumors and leiomyomas originated mainly from the muscularis propria (94.4%) and the muscularis mucosa (56.0%), respectively. Compared with the very low-risk and low-risk groups of stromal tumors according to the National Institute of Health guidelines, the intermediate-risk and high-risk groups were more likely to have a lesion > 3 cm (p < 0.001) and a surface ulcer (p < 0.01) identified by EUS.ConclusionsEUS has good diagnostic value for the diagnosis of upper gastrointestinal SMLs based on the lesion size and the muscle layer of origin. The diagnostic accuracy of EUS lesions is related to the origin, and the diagnostic accuracy is greatest in the mucosal muscularis layer. Stromal tumors > 3 cm and a surface ulcer on EUS are likely to be intermediate or high risk for invasion.
Highlights
Submucosal lesions (SMLs) in the digestive tract refer to abnormal lesions originating from the various layers under the mucosa, and upper gastrointestinal SMLs
We reviewed and compared the distribution, size, endoscopic features, and pathological results of SMLs to determine the diagnostic value of endoscopic ultrasonography (EUS) for SMLs
All patients underwent a routine endoscopy and EUS to confirm the location of the SML in the upper gastrointestinal tract
Summary
Submucosal lesions (SMLs) in the digestive tract refer to abnormal lesions originating from the various layers under the mucosa, and upper gastrointestinal SMLs. Su et al BMC Gastroenterol (2021) 21:365 the lesions in the cavity, but EUS can perform realtime scanning to obtain information regarding the wall layer structure of the digestive tract, the originating layer of the lesions, and the relationship between the extent of lesion infiltration and the surrounding tissues, peripheral lymph nodes and adjacent organs. EUS-guided fineneedle aspiration/biopsy (EUS-FNA/FNB) can further help to obtain cells or tissues for pathological confirmation [2, 3, 7]. This was performed by analyzing the diagnostic consistency rate, the relationship between endoscopic features and invasion risk, and the relationships among the distribution, diameter, origin and pathological properties of the lesions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
