Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma

Table 1 Clinicopathologic characteristics of 114 superficial esophageal carcinomas n (%)

Characteristics	No. of lesions
Location
Upper esophagus	18 (15.8)
Mid-esophagus	72 (63.2)
Lower esophagus	24 (21.1)
Histologic type
Squamous cell carcinoma	108 (94.7)
Adenocarcinoma	3 (2.6)
Neuroendocrine carcinoma	3 (2.6)
Differentiation degree
Well differentiated	43 (37.7)
Moderately differentiated	61 (53.5)
Poorly differentiated	10 (8.8)
Macroscopic shape
Elevated	62 (54.4)
Flat	38 (33.3)
Depressed	14 (12.3)
Circumferential spread
< 1/4	44 (38.6)
1/4–2/4	35 (30.7)
2/4–3/4	16 (14.0)
≥ 3/4	19 (16.7)
Tumor size (cm)
< 3	74 (64.9)
≥ 3	40 (35.1)

Table 2 Endosonographic assessment of the depth of lesions with superficial esophageal carcinoma

EUS	No.	Histopathology			Accuracy of EUS	Overestimation of EUS	Underestimation of EUS
		Mucosal	Submucosal	Advanced
Mucosal	55	45	10	0	81.8%	0%	18.2%
Submucosal	56	11	42	3	75.0%	19.6%	5.3%
Advanced	3	0	0	3	100%	0%	0%
Total	114	56	52	6	78.9%	9.6%	11.4%

EUS: Endoscopic ultrasonography.

Table 3 Accuracy of endosonographic assessment of invasion depth in superficial esophageal carcinoma, according to clinicopathologic characteristics

Characteristics	No. of accurately assessed lesions	Pvalue
Location		0.379
Upper esophagus	16/18
Mid-esophagus	57/72
Lower esophagus	17/24
Histologic type		0.767
Squamous cell carcinoma	85/108
Adenocarcinoma	2/3
Neuroendocrine carcinoma	3/3
Differentiation degree		0.617
Well differentiated	35/43
Moderately differentiated	46/61
Poorly differentiated	9/10
Macroscopic shape		0.486
Elevated	46/62
Flat	32/38
Depressed	12/14
Circumferential spread		0.136
< 1/4	37/44
1/4–2/4	29/35
2/4–3/4	13/16
≥ 3/4	11/19
Tumor size (cm)		0.002
< 3	65/74
≥ 3	25/40

Table 4 Accuracy of endosonographic assessment of lymph node metastasis in superficial esophageal carcinoma, according to clinicopathologic characteristics

Characteristics	No. of accurately assessed lesions	Pvalue
Location		0.137
Upper esophagus	15/16
Mid-esophagus	43/54
Lower esophagus	22/23
Histologic type		1.000
Squamous cell carcinoma	75/88
Adenocarcinoma	2/2
Neuroendocrine carcinoma	3/3
Differentiation degree		0.182
Well differentiated	24/25
Moderately differentiated	48/58
Poorly differentiated	8/10
Macroscopic shape		0.225
Elevated	47/58
Flat	22/23
Depressed	11/12
Circumferential spread		0.356
< 1/4	25/28
1/4-2/4	28/31
2/4-3/4	14/16
≥ 3/4	13/18
Tumor size (cm)		0.769
< 3	47/54
≥ 3	33/39

Table 5 Clinicopathologic characteristics associated with overestimation of invasion depth by endoscopic ultrasonography in superficial esophageal carcinoma

Characteristics	No. of overestimated lesions	Pvalue
Location		0.074
Upper esophagus	2/18
Mid-esophagus	4/72
Lower esophagus	5/24
Histologic type		0.464
Squamous cell carcinoma	10/108
Adenocarcinoma	1/3
Neuroendocrine carcinoma	0/3
Differentiation degree		0.805
Well differentiated	4/43
Moderately differentiated	7/61
Poorly differentiated	0/10
Macroscopic shape		0.491
Elevated	7/62
Flat	2/38
Depressed	2/14
Circumferential spread		0.266
< 1/4	7/44
1/4-2/4	2/35
2/4-3/4	0/16
≥ 3/4	2/19
Tumor size (cm)		0.513
< 3	6/74
≥ 3	5/40

Table 6 Multivariate analysis for endoscopic ultrasonography accuracy according to clinicopathologic factors

Variables1	Odds ratio (95%CI)	Pvalue
Accuracy
Tumor size ≥ 3 cm	0.229 (0.060-0.872)	0.031
Lower esophagus	0.433 (0.127-1.476)	0.181
Overestimation
Lower esophagus	3.393 (0.785-14.664)	0.102
Underestimation
Tumor size ≥ 3 cm	6.208 (1.005-38.338)	0.049
Circumferential spread ≥ 3/4	2.328 (0.542-9.995)	0.256

¹All variables were included in the multivariate analysis, including those variables that were and were not significantly associated with accuracy, overestimation, and underestimation in univariate analyses.

Table 7 Clinicopathologic characteristics associated with underestimation of invasion depth by endoscopic ultrasonography in superficial esophageal carcinoma

Characteristics	No. of underestimated lesions	Pvalue
Location		0.160
Upper esophagus	0/18
Mid-esophagus	11/72
Lower esophagus	2/24
Histologic type		1.000
Squamous cell carcinoma	13/108
Adenocarcinoma	0/3
Neuroendocrine carcinoma	0/3
Differentiation degree		0.903
Well differentiated	4/43
Moderately differentiated	8/61
Poorly differentiated	1/10
Macroscopic shape		0.379
Elevated	9/62
Flat	4/38
Depressed	0/14
Circumferential spread		0.001
< 1/4	0/44
1/4–2/4	4/35
2/4–3/4	3/16
≥ 3/4	6/19
Tumor size (cm)		0.001
< 3	3/74
≥ 3	10/40