Objective   To explore the value of ultrasonic endoscopy in discriminating intramucosal carcinoma from submucosal carcinoma in the upper gastrointestinal tract.   Methods   Preoperative ultrasonic endoscopy was performed in 129 cases with early cancers of the upper gastrointestinal tract. The ultrasonographic images of intraepithelial carcinoma

muscularis mucosae carcinoma

and submucosal carcinoma were analyzed. Endoscopic mucosal resection

endoscopic submucosal dissection

and surgical operation were performed in 34

5

and 90 cases

respectively. The infiltration depth of early cancers was confirmed pathologically after operation.   Results   Ultrasonic endoscopy revealed intraepithelial carcinoma in 30 cases with thickened mucosa epithelial lamina and regular morphology of muscularis mucosae

muscularis mucosae carcinoma in 36 cases with thickened mucosa and muscularis mucosae unclear demarcation but regular morphology of submucosa

muscularis mucosae carcinoma in 6 cases with partially thickened submucosa but regular morphology

submucosal carcinoma in 57 cases with changed submucosal morphology (thinned in 8 cases

thickened in 6 cases

twisted in 5 cases

irregular in 10 cases partially discontinued in 12 cases

and unclear of muscularis mucosae and submucosa ambit in 16 cases). Pathological examination after treatment reported 78 cases of intramucosal carcinoma and 51 cases of submucosal carcinoma. The specificity and sensibility in intramucosal carcinoma by ultrasonic endoscopy were 92.2% (47/51) and 87.2% (68/78) while in submucosal carcinoma were 87.2% (68/78) and 92.2% (47/51). The diagnostic accuracy in differentiating intramucosal carcinoma from submucosal carcinoma by ultrasonic endoscopy was 89.1% (115/129).   Conclusion   Ultrasonic endoscopy is effective in differentiating intramucosal carcinoma from submucosal carcinoma in the upper gastrointestinal tract.