Endoscopic ultrasonography-related diagnostic accuracy and clinical significance on small rectal neuroendocrine neoplasms

This research aimed to examine the diagnostic accuracy and clinical significance of endoscopic ultrasonography(EUS)in the context of small rectal neuroendocrine neoplasms(NENs).A total of 108 patients with rectal subepithelial lesions(SELs)with a diameter of<20 mm were included in the analysis.The diagnosis and depth assessment of EUS was compared to the histology findings.The prevalence of NENs in rectal SELs was 78.7%(85/108).The sensitivity of EUS in detecting rectal NENs was 98.9%(84/85),while the specificity was 52.2%(12/23).Overall,the diagnostic accuracy of EUS in identifying rectal NENs was 88.9%(96/108).The overall accuracy rate for EUS in assessing the depth of invasion in rectal NENs was 92.9%(78/84).Therefore,EUS demonstrates reasonable diagnostic accuracy in detecting small rectal NENs,with good sensitivity but inferior specificity.EUS may also assist physicians in assessing the depth of invasion in small rectal NENs before endoscopic excision.

Prognostic prediction in gastric cancer patients without serosal invasion: comparative study between UICC 7^(th) edition and JCGS 13^(th) edition N-classification systems

Objective： T-stage and N-stage have been proven to be the most important factors influencing survival in gastric cancer patients, and have been accepted for use in the Japanese Classification of Gastric Carcinoma（JCGC） and the Union International Cancer Control（UICC-TNM） staging systems. The purpose of this study was to compare the prognostic values of the different N classification systems in gastric cancer patients without serosal invasion.Methods： We retrospectively compared the clinicopathological results of 1,115 patients with primary gastric cancer who underwent curative gastric resection.Results： Serosal invasion was identified in 212 of 1,115 patients（19.0%）, and it was associated with lymph node metastasis according to the JCGC^13th（P〈0.001） and TNM^7th（P〈0.001） systems. The 5-year survival rate for the serosal invasion-negative patients（78.2%） was significantly higher than that for the serosal invasion-positive patients（31.1%）（P〈0.001）. Multivariate Cox regression survival analysis showed that depth of invasion（P=0.013）, 13 th JCGC PN stage（P〈0.001）, and 7th TNM PN stage（P〈0.001） were independent prognostic factors for serosal invasion-negative gastric cancer patients.Conclusions： The prognosis of gastric cancer patients with serosal invasion is very poor. Both the 13 th JCGC and 7th TNM N-staging systems were able to accurately estimate the prognosis of gastric cancer patients, but the 7th TNM system was simpler and easier to use.