Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2024; 30(41): 4439-4448
Published online Nov 7, 2024. doi: 10.3748/wjg.v30.i41.4439
Clinical application of oral contrast-enhanced ultrasound in evaluating the preoperative T staging of gastric cancer
Yu Liang, Wan-Yi Jing, Jun Song, Qiu-Xin Wei, Zhi-Qing Cai, Juan Li, Ping Wu, Dong Wang, Yi Ma
Yu Liang, Wan-Yi Jing, Jun Song, Qiu-Xin Wei, Zhi-Qing Cai, Ping Wu, Dong Wang, Yi Ma, Department of Ultrasound, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
Juan Li, Department of Pathology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
Co-first authors: Yu Liang and Wan-Yi Jing.
Co-corresponding authors: Dong Wang and Yi Ma.
Author contributions: Liang Y, Jing WY, Song J, Wei QX, Cai ZQ, Li J, Wu P, Wang D, and Ma Y collaboratively conceived and designed the study; Liang Y, Jing WY, Song J, and Wei QX carried out data collection and ultrasound image analysis; Li J was in charge of pathological analysis and interpretation of results; Wu P and Cai ZQ were responsible for data analysis and statistical evaluation; Ma Y, Wang D, and Liang Y drafted the manuscript. All authors have read and approved the final manuscript. Liang Y and Jing WY jointly took charge of the research analysis and implementation, performed data analysis, and co-authored the initial draft of the manuscript. They made equal and significant contributions to the successful completion of the project, thus being recognized as co-first authors. Wang D and Ma Y, as co-corresponding authors, played pivotal roles in experimental design, data interpretation, and manuscript preparation. Wang D oversaw the entire project, conducted literature searches, and revised and submitted the initial manuscript focusing on the clinical application of OCEUS in gastric cancer T staging. Ma Y significantly contributed to the in-depth analysis of OCEUS data, re-interpretation of results, meticulous creation of figures, and comprehensive literature review and synthesis. Her work provided a solid data support and theoretical foundation for the current manuscript, enabling it to focus more on evaluating the accuracy and reliability of OCEUS in preoperative T staging diagnosis of gastric cancer. The collaboration between Wang D and Ma Y is crucial for the publication of this manuscript and other manuscripts currently in preparation.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of Sichuan Provincial People's Hospital (Approval No. 2022-344).
Informed consent statement: The Hospital Ethics Review Board agreed to waive the signature of informed consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Ma, MSc, Doctor, Department of Ultrasound, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32 West Second Section, First Ring Road, Qingyang District, Chengdu 610072, Sichuan Province, China. tougao20220918@126.com
Received: May 30, 2024
Revised: September 8, 2024
Accepted: September 23, 2024
Published online: November 7, 2024
Processing time: 145 Days and 19 Hours
Abstract
BACKGROUND

Oral contrast-enhanced ultrasound (OCEUS) is widely used in the noninvasive diagnosis and screening of gastric cancer (GC) in China.

AIM

To investigate the clinical application of OCEUS in evaluating the preoperative T staging of gastric cancer.

METHODS

OCEUS was performed before the operation, and standard ultrasound images were retained. The depth of infiltration of GC (T-stage) was evaluated according to the American Joint Committee on Cancer 8th edition of the tumor-node-metastasis staging criteria. Finally, with postoperative pathological staging as the gold standard reference, the sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic value of OCEUS T staging were evaluated.

RESULTS

OCEUS achieved diagnostic accuracy rates of 76.6% (T1a), 69.6% (T1b), 62.7% (T2), 60.8% (T3), 88.0% (T4a), and 88.7% (T4b), with an average of 75.5%. Ultrasonic T staging sensitivity exceeded 62%, aside from T1b at 40.3%, while specificity was over 91%, except for T3 with 83.5%. The Youden index was above 60%, with T1b and T2 being exceptions. OCEUS T staging corresponded closely with pathology in T4b (kappa > 0.75) and moderately in T1a, T1b, T2, T3, and T4a (kappa 0.40-0.75), registering a concordance rate exceeding 84%.

CONCLUSION

OCEUS was effective, reliable, and accurate in diagnosing the preoperative T staging of GC. As a noninvasive diagnostic technique, OCEUS merits clinical popularization.

Keywords: Gastric cancer; Oral contrast-enhanced ultrasound; Tumor-node-metastasis staging; Noninvasive diagnosis and screening; Clinical value

Core Tip: This study evaluated the efficacy of oral contrast-enhanced ultrasound (OCEUS) for preoperative T staging of gastric cancer, adhering to the American Joint Committee on Cancer 8th edition criteria. The results demonstrated the high diagnostic accuracy, reliability, and noninvasive advantages of OCEUS, supporting its use as a valuable tool for clinical staging and potentially improving treatment strategies for patients with gastric cancer.