To probe into the value of gastric wall thickness measured by oral contrast trans abdominal gastric ultrasonography in evaluating gastric lesions.

From January 2015 to December 2018, 3573 patients underwent gastroscopic examination and gastric ultrasonography at the Eighth Affiliated Hospital of Sun Yat-Sen University. The stomach cavity, gastric wall, and perigastric structure were observed by gastric ultrasonography, and the thickness of the gastric wall was measured. The results of gastric ultrasonography and gastroscopy were analyzed. The ROC curve of gastric wall thickness was plotted and the area under the ROC curve, the best cutoff value, sensitivity, and specificity were calculated. Consistency analysis was performed on the results of gastric wall thickness measured by gastric ultrasonography and gastroscopy in the diagnosis of gastric lesions using linear weighted Kappa test.

Twenty patients were confirmed with gastric cancer by postoperative pathology. Gastric ultrasonography screening revealed 18 cases of gastric cancer, which were proved to be gastric adenocarcinoma by pathology. Gastric ultrasonography missed and misdiagnosed two cases of gastric cancer each. Gastroscopy missed one case. The diagnostic criteria were surgical pathology, pathological results of gastroscopic biopsy, and combined gastroscopic clinical follow-up results. The ROC curves of normal and diseased gastric wall thickness were plotted according to the pathological results of gastroscopic biopsy and clinical follow-up results. The area under the ROC curve was 0.946 (95% CI: 0.930-0.962), the best cutoff value was 5.5 mm, and the diagnostic sensitivity and specificity were 97.5% and 98.3%, respectively. Gastric mass and non-mass were judged according to the results of gastroscopy and pathology, and the ROC curves of gastric mass and non-mass were plotted. The area under the ROC curve was 0.829 (95% CI: 0.758-0.900), the best cutoff value was 9.5 mm, and the diagnostic sensitivity and specificity were 79.7% and 75.9%, respectively. Based on the results of ROC curve analysis, different lesions were diagnosed according to the thickness of the gastric wall. Gastric wall thickness＜6 mm was determined as normal or non-erosive gastritis, 6 mm≤gastric wall thickness≤9 mm was determined as erosive gastritis, and gastric wall thickness＞9 mm was determined as mass. The consistency between the results of gastric wall thickness evaluation and endoscopic examination was analyzed. The Kappa value was 0.792 (P＜0.001).

Evaluation of gastric wall thickness is consistent with the results of gastroscopy. Gastric ultrasonography, as a simple and rapid screening method for gastric diseases, is of great significance for screening gastric cancer and other gastric diseases. It is worth popularizing in people with routine physical examination.