Diagnosis of depth of invasion for patients with superficial esophageal cancer: differentiating upper submucosal versus middle or deep submucosal invasion is important for deciding treatment strategy

摘要

We have read with great interest the systematic review by Thosani et al.1 They performed a meta-analysis of 19 international studies on the diagnostic accuracy of EUS in differentiating mucosal from submucosal invasion of superficial esophageal cancers (SECs), and they concluded that overall, EUS has good accuracy in staging SECs. However, they also stated that multiple factors, including the location and type of lesion, the method and frequency of EUS probe, and the experience of the endosonographer, can affect the diagnostic accuracy of EUS. They finally recommended examination with EUS first to rule out infiltration of the muscuiaris propria (T2), followed by EMR with histologic examination of the resection specimen as the diagnostic algorithm for evaluation of SEC.