Suzuki M, Sakurazawa N, Hagiwara N, Kogo H, Haruna T, Ohashi R, Yoshida H. Usefulness of shear-wave elastography for detection of lymph node metastasis in esophageal and gastric cancer. World J Gastrointest Oncol 2025; 17(4): 101925 [DOI: 10.4251/wjgo.v17.i4.101925]
Corresponding Author of This Article
Mikito Suzuki, MD, Surgeon, Department of Gastroenterological Surgery, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ward, Tokyo 113-8603, Japan. mkt1118@nms.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Mikito Suzuki, Nobuyuki Sakurazawa, Nobutoshi Hagiwara, Hideki Kogo, Hiroshi Yoshida, Department of Gastroenterological Surgery, Nippon Medical School, Tokyo 113-8603, Japan
Takahiro Haruna, Ryuji Ohashi, Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo 113-8603, Japan
Co-first authors: Mikito Suzuki and Nobuyuki Sakurazawa.
Author contributions: Suzuki M, Sakurazawa N, and Hagiwara N conceived this study; Kogo H and Haruna T processed the experimental data; Suzuki M performed the analysis, drafted the manuscript and designed the figures; Sakurazawa N supported statistical analyses; Yoshida H and Ohashi R supervised the project; All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Nippon Medical School Hospital (No. B-2022-582).
Informed consent statement: Written consent was obtained from all the patients in this study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Data is available upon reasonable request to the corresponding author.
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: Mikito Suzuki, MD, Surgeon, Department of Gastroenterological Surgery, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ward, Tokyo 113-8603, Japan. mkt1118@nms.ac.jp
Received: October 1, 2024 Revised: January 17, 2025 Accepted: February 5, 2025 Published online: April 15, 2025 Processing time: 175 Days and 13.3 Hours
Abstract
BACKGROUND
Tissue hardness is closely related to disease pathophysiology. Shear-wave elastography (SWE) is a simple and noninvasive ultrasound technique that has been used to evaluate the presence of lymph node metastases and differentiate between benign and malignant tumors.
AIM
To investigate SWE usefulness in measuring lymph node hardness to predict metastasis presence or absence in surgically removed lymph nodes.
METHODS
This observational study obtained data from patients who underwent surgery for esophageal or gastric cancer at Nippon Medical School Hospital. The hardness of the surgically removed lymph nodes was measured using SWE. The lymph nodes with hardness values ≥ 2.2 m/s were considered clinically positive for metastasis, whereas those with lower hardness values were considered clinically negative. The lymph nodes subsequently underwent pathological examination to determine the presence of metastasis, and the SWE results and pathological assessments were compared.
RESULTS
A total of 1077 lymph nodes were evaluated; 18 and 15 cases of esophageal and gastric cancer were identified, respectively. The optimal cutoff value for lymph node size was calculated to be 5.1 mm, and the area under the curve value was 0.74 (95% confidence interval: 0.69-0.84). When limited to a lymph node larger than the cut off value, the SWE sensitivity and specificity for metastasis identification were 0.76 and 0.82, respectively.
CONCLUSION
SWE was useful in detecting lymph node metastases in the upper gastrointestinal tract.
Core Tip: Evaluating lymph node metastasis from malignant tumors is crucial because it significantly influences treatment planning and prognosis. Shear-wave elastography is a simple, noninvasive, and objective ultrasound method for measuring tissue stiffness. In this study, the hardness of lymph nodes removed during surgery for esophageal and gastric cancer was measured using shear-wave elastography and compared with the pathological examination. The sensitivity and specificity were 0.76 and 0.82, respectively, whereas the area under the curve was 0.74 (95% confidence interval: 0.69-0.84). Shear-wave elastography was useful in detecting lymph node metastases in the upper gastrointestinal tract.
