RESUMO
Objective:To investigate the application value of endoscopic ultrasound (EUS) in tumor staging of adenocarcinoma of the esophagogastric junction (AEG) after neoadjuvant concurrent chemoradiotherapy.Methods:The clinical data of 40 patients diagnosed with stage Ⅲ AEG and treated with neoadjuvant concurrent chemoradiotherapy from January 2016 to December 2021 in the First Affiliated Hospital of Hebei North University were retrospectively analyzed. EUS was used to perform preoperative tumor staging after neoadjuvant concurrent chemoradiotherapy to evaluate the therapeutic effect, and the consistency between EUS and postoperative pathological staging was analyzed.Results:In 40 AEG patients after neoadjuvant chemoradiotherapy, the EUS staging was stage yp-uT 2 in 12 cases, stage yp-uT 3 in 18 cases, and stage yp-uT 4 in 10 cases. The postoperative pathological staging was stage pT 1 in 2 cases, stage pT 2 in 14 cases, stage pT 3 in 12 cases, and stage pT 4 in 12 cases. Taking postoperative pathological results as the gold standard, the accuracy of EUS for T staging after neoadjuvant chemoradiotherapy was 62.5%, and the accuracy, sensitivity and specificity for stage T 2 were 58.3%, 50.0% and 80.8%, respectively. The accuracy, sensitivity and specificity for stage T 3 were 61.1%, 91.7% and 75.0%, respectively. The accuracy, sensitivity and specificity for stage T 4 were 70.0%, 58.3% and 89.3%, respectively. The Kappa value of the consistency test between yp-uT staging and pT staging was 0.453. The EUS staging of lymph nodes was stage yp-uN 0 in 15 cases, stage yp-uN 1 in 10 cases, stage yp-uN 2 in 10 cases, and stage yp-uN 3 in 5 cases. The postoperative pathological staging was stage pN 0 in 18 cases, stage pN 1 in 7 cases, stage pN 2 in 7 cases, and stage pN 3 in 8 cases. Taking postoperative pathological results as the gold standard, the accuracy rate of EUS for N staging after neoadjuvant chemoradiotherapy was 57.5%, and the accuracy, sensitivity and specificity of EUS for stage N 0 were 73.3%, 61.1% and 81.8%, respectively. The accuracy, sensitivity and specificity for stage N 1 were 50.0%, 71.4% and 84.8%, respectively. The accuracy, sensitivity and specificity for stage N 2 were 40.0%, 57.1% and 81.8%, respectively. The accuracy, sensitivity and specificity for stage N 3 were 60.0%, 37.5% and 93.8%, respectively. The Kappa value of the consistency test between yp-uN staging and pN staging was 0.409. Conclusions:EUS is not accurate for T staging in patients with stage Ⅲ AEG after neoadjuvant therapy, but has high sensitivity for stage T 3 and high specificity for stage T 4. EUS has low sensitivity for N staging in patients with stage Ⅲ AEG after neoadjuvant therapy, but has high specificity for stage N 3.