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Erschienen in: Wiener klinische Wochenschrift 1-2/2013

01.01.2013 | original article

The usefulness of ulcer size and location in the differential diagnosis of benign and malignant gastric ulcer

verfasst von: Erdem Koçak, MD, Fatma Kılıç, MD, Erdem Akbal, MD, Adnan Taş, MD, Seyfettin Köklü, MD, Levent Filik, MD, İbrahim Bıyıkoğlu, MD, Bilal Ergül, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 1-2/2013

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Summary

Aim

Gastric cancer can present as a gastric ulcer, which can mimic a benign gastric ulcer. In this study, we aimed to investigate the value of gastric ulcer size and location in the differential diagnosis of benign and malignant gastric ulcers.

Methods

We reviewed retrospectively the upper endocopic findings of 14,400 patients between April 2008 and March 2010. Total 276 patients with gastric ulcers were divided into two groups according to histopathological examination. Ulcer location, size, age, and gender were compared between the two groups.

Results

The predominant region of ulcer location was the corpus for the malignant ulcer group and the antrum for the benign ulcer group. The malignant ulcer ratios according to region in the whole group were: cardia 19 ulcers with 14 malignant (73.68 %), corpus 70 ulcers with 38 malignant (54.2 %), angulus 45 ulcers with 6 malignant (13.3 %), and antrum 142 ulcers with 20 malignant (14.8 %), respectively. The median size of ulcer was significantly higher in the malignant ulcer group compared with the benign ulcer group (p < 0.001).

Conclusions

These results suggest that the location and diameter of gastric ulcers may be used as a marker of risk factors for developing gastric cancer.
Literatur
1.
Zurück zum Zitat Lau M, Le A, El-Serag HB. Noncardia gastric adenocarcinoma remains an important and deadly cancer in the United States: secular trends in incidence and survival. Am J Gastroenterol. 2006;101:2485–92.PubMedCrossRef Lau M, Le A, El-Serag HB. Noncardia gastric adenocarcinoma remains an important and deadly cancer in the United States: secular trends in incidence and survival. Am J Gastroenterol. 2006;101:2485–92.PubMedCrossRef
2.
Zurück zum Zitat Ito M, Haruma K, Kamada T, Mihara M, Kim S, Kitadai Y, Sumii M, Tanaka S, Yoshihara M, Chayama K. Helicobacter pylori eradication therapy improves atrophic gastritis and intestinal metaplasia: a 5-year prospective study of patients with atrophic gastritis. Aliment Pharmacol Ther. 2002;16:1449–56.PubMedCrossRef Ito M, Haruma K, Kamada T, Mihara M, Kim S, Kitadai Y, Sumii M, Tanaka S, Yoshihara M, Chayama K. Helicobacter pylori eradication therapy improves atrophic gastritis and intestinal metaplasia: a 5-year prospective study of patients with atrophic gastritis. Aliment Pharmacol Ther. 2002;16:1449–56.PubMedCrossRef
3.
Zurück zum Zitat You WC, Blot WJ, Li JY, Chang YS, Jin ML, Kneller R, Zhang L, Han ZX, Zeng XR, Liu WD. Precancerous gastric lesions in a population at high risk of stomach cancer. Cancer Res. 1993;53:1317–21.PubMed You WC, Blot WJ, Li JY, Chang YS, Jin ML, Kneller R, Zhang L, Han ZX, Zeng XR, Liu WD. Precancerous gastric lesions in a population at high risk of stomach cancer. Cancer Res. 1993;53:1317–21.PubMed
4.
Zurück zum Zitat Joossens JV, Hill MJ, Elliott P, Stamler R, Lesaffre E, Dyer A, Nichols R, Kesteloot H. Dietary salt, nitrate and stomach cancer mortality in 24 countries. Int J Epidemiol. 1996;25:494–504.PubMedCrossRef Joossens JV, Hill MJ, Elliott P, Stamler R, Lesaffre E, Dyer A, Nichols R, Kesteloot H. Dietary salt, nitrate and stomach cancer mortality in 24 countries. Int J Epidemiol. 1996;25:494–504.PubMedCrossRef
5.
Zurück zum Zitat Tredaniel J, Boffetta P, Buiatti E, Saracci R, Hirsch A. Tobacco smoking and gastric cancer: review and meta-analysis. Int J Cancer. 1997;72:565–73.PubMedCrossRef Tredaniel J, Boffetta P, Buiatti E, Saracci R, Hirsch A. Tobacco smoking and gastric cancer: review and meta-analysis. Int J Cancer. 1997;72:565–73.PubMedCrossRef
6.
Zurück zum Zitat Neugut AI, Hayek M, Howe G. Epidemiology of gastric cancer. Semin Oncol. 1996;23:281–91.PubMed Neugut AI, Hayek M, Howe G. Epidemiology of gastric cancer. Semin Oncol. 1996;23:281–91.PubMed
7.
Zurück zum Zitat Zhang Z. The risk of gastric cancer in patients with duodenal and gastric ulcer: research progresses and clinical implications. J Gastrointest Cancer. 2007;38:38–45.PubMedCrossRef Zhang Z. The risk of gastric cancer in patients with duodenal and gastric ulcer: research progresses and clinical implications. J Gastrointest Cancer. 2007;38:38–45.PubMedCrossRef
8.
Zurück zum Zitat Hansson LE, Nyren O, Hsing AW, Bergstrom R, Josefsson S, Chow WH, Fraumeni JF Jr, Adami HO. The risk of stomach cancer in patients with gastric or duodenal ulcer disease. N Engl J Med. 1996;335:242–9.PubMedCrossRef Hansson LE, Nyren O, Hsing AW, Bergstrom R, Josefsson S, Chow WH, Fraumeni JF Jr, Adami HO. The risk of stomach cancer in patients with gastric or duodenal ulcer disease. N Engl J Med. 1996;335:242–9.PubMedCrossRef
9.
Zurück zum Zitat Graham DY, Schwartz JT, Cain GD, Gyorkey F. Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma. Gastroenterology. 1982;82:228–31.PubMed Graham DY, Schwartz JT, Cain GD, Gyorkey F. Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma. Gastroenterology. 1982;82:228–31.PubMed
10.
Zurück zum Zitat Bytzer P. Endoscopic follow-up study of gastric ulcer to detect malignancy: is it worthwhile? Scand J Gastroenterol. 1991;26:1193–9.PubMedCrossRef Bytzer P. Endoscopic follow-up study of gastric ulcer to detect malignancy: is it worthwhile? Scand J Gastroenterol. 1991;26:1193–9.PubMedCrossRef
11.
Zurück zum Zitat Eckardt VF, Giessler W, Kanzler G, Bernhard G. Does endoscopic follow-up improve the outcome of patients with benign gastric ulcers and gastric cancer? Cancer. 1992 15 Jan;69:301–5.PubMedCrossRef Eckardt VF, Giessler W, Kanzler G, Bernhard G. Does endoscopic follow-up improve the outcome of patients with benign gastric ulcers and gastric cancer? Cancer. 1992 15 Jan;69:301–5.PubMedCrossRef
12.
Zurück zum Zitat Bustamante M, Devesa F, Borghol A, Ortuno J, Ferrando MJ. Accuracy of the initial endoscopic diagnosis in the discrimination of gastric ulcers: is endoscopic follow-up study always needed? J Clin Gastroenterol. 2002;35:25–8.PubMedCrossRef Bustamante M, Devesa F, Borghol A, Ortuno J, Ferrando MJ. Accuracy of the initial endoscopic diagnosis in the discrimination of gastric ulcers: is endoscopic follow-up study always needed? J Clin Gastroenterol. 2002;35:25–8.PubMedCrossRef
13.
Zurück zum Zitat Xu CY, Shen JG, Shen JY, Chen WJ, Wang LB. Ulcer size as a novel indicator marker is correlated with prognosis of ulcerative gastric cancer. Dig Surg. 2009;26:312–6.PubMedCrossRef Xu CY, Shen JG, Shen JY, Chen WJ, Wang LB. Ulcer size as a novel indicator marker is correlated with prognosis of ulcerative gastric cancer. Dig Surg. 2009;26:312–6.PubMedCrossRef
14.
Zurück zum Zitat Freedman ND, Chow WH, Gao YT, Shu XO, Ji BT, Yang G, Lubin JH, Li HL, Rothman N, Zheng W, Abnet CC. Menstrual and reproductive factors and gastric cancer risk in a large prospective study of women. Gut. 2007;56:1671–7. Freedman ND, Chow WH, Gao YT, Shu XO, Ji BT, Yang G, Lubin JH, Li HL, Rothman N, Zheng W, Abnet CC. Menstrual and reproductive factors and gastric cancer risk in a large prospective study of women. Gut. 2007;56:1671–7.
15.
Zurück zum Zitat Saini SD, Eisen G, Mattek N, Schoenfeld P. Utilization of upper endoscopy for surveillance of gastric ulcers in the United States. Am J Gastroenterol. 2008;103:1920–5.PubMedCrossRef Saini SD, Eisen G, Mattek N, Schoenfeld P. Utilization of upper endoscopy for surveillance of gastric ulcers in the United States. Am J Gastroenterol. 2008;103:1920–5.PubMedCrossRef
16.
Zurück zum Zitat Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Time trends in gastric carcinoma: changing patterns of type and location. Am J Gastroenterol. 1992;87:572–9.PubMed Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Time trends in gastric carcinoma: changing patterns of type and location. Am J Gastroenterol. 1992;87:572–9.PubMed
17.
Zurück zum Zitat Zheng T, Mayne ST, Holford TR, Boyle P, Liu W, Chen Y, Mador M, Flannery J. The time trend and age-periodcohort effect on incidence of adenocarcinoma of the stomach in Connecticut from 1955–1989. Cancer. 1993;72:330–40.PubMedCrossRef Zheng T, Mayne ST, Holford TR, Boyle P, Liu W, Chen Y, Mador M, Flannery J. The time trend and age-periodcohort effect on incidence of adenocarcinoma of the stomach in Connecticut from 1955–1989. Cancer. 1993;72:330–40.PubMedCrossRef
18.
Zurück zum Zitat Morales TG, Sampliner RE, Bhattacharyya A. Intestinal metaplasia of the gastric cardia. Am J Gastroenterol. 1997;92:414–8.PubMed Morales TG, Sampliner RE, Bhattacharyya A. Intestinal metaplasia of the gastric cardia. Am J Gastroenterol. 1997;92:414–8.PubMed
19.
Zurück zum Zitat El-Serag HB, Sonnenberg A. Opposing time trends of peptic ulcer and reflux disease. Gut. 1998;43:327–33.PubMedCrossRef El-Serag HB, Sonnenberg A. Opposing time trends of peptic ulcer and reflux disease. Gut. 1998;43:327–33.PubMedCrossRef
20.
Zurück zum Zitat Milosavljevic TN, Jovanovic IR, Krstic MN, Ugljesic MM, Popovic DS, Dugalic PD, Krstic R, Djuranovic SP, Spuran M, Mijalkovic NS. Opposing time trends of gastric cardia cancer and duodenal ulcer. Ann Gastroenterol. 2008;15:308–12. Milosavljevic TN, Jovanovic IR, Krstic MN, Ugljesic MM, Popovic DS, Dugalic PD, Krstic R, Djuranovic SP, Spuran M, Mijalkovic NS. Opposing time trends of gastric cardia cancer and duodenal ulcer. Ann Gastroenterol. 2008;15:308–12.
Metadaten
Titel
The usefulness of ulcer size and location in the differential diagnosis of benign and malignant gastric ulcer
verfasst von
Erdem Koçak, MD
Fatma Kılıç, MD
Erdem Akbal, MD
Adnan Taş, MD
Seyfettin Köklü, MD
Levent Filik, MD
İbrahim Bıyıkoğlu, MD
Bilal Ergül, MD
Publikationsdatum
01.01.2013
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 1-2/2013
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-012-0309-8

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