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ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1509628
This article is part of the Research TopicAdvances in Medical Imaging for Precision Diagnostic and Therapeutic Applications in Digestive DiseasesView all 8 articles
Endoscopic ultrasound with submucosal saline injection improves the accuracy of T1a and T1b staging in superficial esophageal squamous cell carcinoma
Provisionally accepted- Department of Medical Oncology, Shandong Cancer Hospital, Shandong University, Jinan, China
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Background: Endoscopic ultrasound (EUS) is important for diagnosing and staging esophageal cancer. However, substantial variability in the diagnostic and staging accuracy of EUS, especially in early-stage cancers, affects patients' treatment choices and quality of life.Aims: To explore whether conventional endoscopic ultrasonography (EUS-C) combined with submucosal saline injection (EUS-SSI) improves diagnostic accuracy in preoperative T1a and T1b staging in superficial esophageal squamous cell carcinoma (SESCC).: Patients with SESCC first underwent EUS-C. Then, they received SSI and underwent a repeat EUS. The diagnostic accuracy of EUS-C and EUS-SSI was evaluated based on the final postoperative pathology results.Results: A total of 92 patients with endoscopically diagnosed SESCC were included in the study.Postoperative pathology confirmed superficial SESCC in all patients (T1a stage, n=77; T1b stage, n=15). EUS-C correctly identified 54 of 77 patients with T1a cancer and 9 of 15 patients with T1b cancer, whereas EUS-SSI identified 68 of 77 patients with T1a cancer and 10 of 15 patients with T1b cancer. EUS-SSI was more accurate than EUS-C in diagnosing T1a and T1b stage SESCC (84.8% and 68.5%, respectively).EUS-SSI differentiates between T1a and T1b stages of superficial SESCC with better diagnostic accuracy than EUS-C, thereby reducing the rate of over-staging.
Keywords: Endoscopic ultrasonography, Superficial esophageal squamous cell carcinoma, Submucosal Saline Injection, Tumour stage, Treatment options
Received: 11 Oct 2024; Accepted: 10 Apr 2025.
Copyright: © 2025 Zhang, Chen, Gao, Liu, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dongyang Wang, Department of Medical Oncology, Shandong Cancer Hospital, Shandong University, Jinan, China
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