[Endoscopic ultrasound in TN staging of stomach cancer. A comparison with computerized tomography and conventional ultrasound].

64 patients with histologically proven gastric carcinoma were investigated by endosonography (EUS), computed tomography (CT) and conventional transcutaneous sonography (US). In 50 patients a resection of the stomach was performed and the histological findings were compared with the results of preoperative staging. In all cases EUS was successful in demonstrating the tumour. With CT tumour visualisation was possible in 17 (35.4%), with US in 7 (14.6%) cases. The pT-stage was correctly determined preoperatively by EUS in 40 (81.6%) with CT and US in only 12 (25%) and 4 (8.3%) patients, respectively. The staging accuracy of EUS amounted to 80% in T1-, 81% in T2-, 100% in T3-, and 67% in T4-stage. The sensitivity in demonstrating lymph node metastases was 81.3% for EUS, 25.8% for CT and 9.7% for US. The specificity in this regard was 72.2% for EUS, 83.3% for CT and 100% for EUS. The overall accuracy for determination of pN-stage was 78% for EUS, 47.9% for CT and 41.7% for US. EUS is clearly superior to CT and US in the locoregional TN-staging of gastric carcinoma.