Diagnostic evaluation of endoscopic ultrasonography with submucosal saline injection for differentiating between T1a and T1b early gastric cancer

Table 1 Clinical features, endoscopic ultrasonography findings before and after submucosal saline injection, and pathological results of 24 patients with early gastric cancer

Patient No.	Age	Sex	Location	Size (max, mm)	Endoscopic morphology (EGC type)	Ulcer	EUS-assessed preoperative stage		Final pathology	Type of resection	Differentiation	Regional LN invasion	Vascular invasion
							Before SSI (EUS-only)	After SSI (EUS-SSI)
1	72	M	Lower third	20	0-III	Y	T1a	T1b	T1b (sm3)	Surgery	Mod
2	64	M	Lower third	20	0-IIc		T1b	T1b	T1b (sm1)	Surgery	Poor (signet ring)	Y
3	59	M	Lower third	10	0-IIc		T1b	T1b	T1b (sm1)	Surgery	Poor
4	53	M	Upper third	27	0-IIa		T1a	T1a	T1a	Surgery	Mod
5	56	F	Lower third	38	0-IIc		T1b	T1a	T1a	Surgery	Poor
6	73	M	Upper third	22	0-IIc		T1b	T1a	T1a	Surgery	Mod
7	62	M	Mid third	65	0-IIc		T1b	T1a	T1a	Surgery	Mod
8	68	M	Upper third	8	0-IIb		T1a	T1a	T1a	ESD	Well
9	69	M	Lower third	15	0-IIa		T1a	T1a	T1a	ESD	Well
10	71	M	Lower third	17	0-IIb		T1b	T1a	T1a	ESD	Poor
11	54	F	Lower third	25	0-IIc		T1b	T1a	T1a	Surgery	Poor (signet ring)
12	82	M	Upper third	15	0-IIb		T1a	T1a	T1b (sm1)	ESD	Poor
13	71	F	Lower third	25	0-IIc		T1b	T1b	T1b (sm3)	Surgery	Poor	Y	Y
14	36	F	Lower third	20	0-IIc		T1a	T1b	T1b (sm3)	Surgery	Poor	Y
15	60	M	Lower third	10	0-IIc		T1a	T1a	T1a	ESD	Mod
16	62	F	Mid third	50	0-IIc		T2	T1b	T1b (sm3)	Surgery	Poor
17	74	F	Upper third	25	0-IIb		T1a	T1a	T1b (sm1)	Surgery	Poor
18	60	F	Upper third	15	0-IIa		T1a	T1b	T2	Surgery	Poor (signet ring)
19	80	F	Lower third	15	0-IIb		T1a	T1b	T1a	ESD	Poor
20	48	F	Lower third	45	0-IIc		T1a	T1a	T1b (sm3)	Surgery	Poor
21	72	F	Lower third	10	0-IIc		T1a	T1a	T1b (sm1)	ESD	Mod
22	50	M	Lower third	27	0-IIb		T1a	T1a	T1a	ESD	Well
23	74	M	Upper third	15	0-IIc		T1b	T1a	T1a	Surgery	Mod
24	76	M	Upper third	23	0-Is		T1b	T1a	T1a	Surgery	Well

EGC: Early gastric cancer; EUS: Endoscopic ultrasonography; SSI: Submucosal saline injection.

Table 2 Preoperative and postoperative stages for early gastric cancer in the endoscopic ultrasonography after submucosal saline injection and endoscopic ultrasonography -only examinations

Preoperative EUS reported stage	Postoperative pathologic stage
	T1a	T1b
EUS-SSI, n (%)
T1a	12 (92.3)	4 (40)
T1b	1 (7.7)	6 (60)
EUS-only, n (%)
T1a	6 (46.2)	6 (66.7)
T1b	7 (53.8)	3 (33.3)

EUS: Endoscopic ultrasonography; SSI: Submucosal saline injection.

Table 3 The misdiagnosis rate for T staging of early gastric cancer in the endoscopic ultrasonography after submucosal saline injection and endoscopic ultrasonography -only examinations

	EUS-only	EUS-SSI
Overstaging, n (%)	8 (33.3)	1 (4.2)
Understaging, n (%)	7 (29.2)	5 (20.8)

EUS: Endoscopic ultrasonography; SSI: Submucosal saline injection.