Meyer C, Keller D, Bur F, Hollender L F
Sem Hop. 1979;55(41-42):1917-20.
The giant stomach ulcer can be defined as a crater measuring more than 30 mm in diameter. This variety of stomach ulcer represents 10-15% of the whole range of gastric ulcers, but they are not quite different from the nosologic point of view. It appears effectively that no etiopathogenic clinical or evolving particular factors can distinguish this kind of ulcer from the niches of normal size. To be taken into consideration is the risk of transforming into cancer which is multiplied by 3 or 5 times when compared with normal stomach ulcers, whence the importance of the endoscopy with many biopsies. In spite of the endoscopy the percentage of error is 5%, this is the reason for which, when in doubt, the more or less extensive gastric resection of the total gastrectomy is required with even more necessity then in normal cases of ulcers.
巨大胃溃疡可定义为直径超过30毫米的溃疡灶。这种类型的胃溃疡占所有胃溃疡的10% - 15%,但从疾病分类学角度来看,它们与其他类型并无太大差异。实际上,似乎没有任何致病的临床或病情发展的特殊因素能将这种溃疡与正常大小的溃疡龛区分开来。需要考虑的是其癌变风险,与正常胃溃疡相比,其癌变风险会增加3至5倍,因此多次活检的内镜检查至关重要。尽管进行了内镜检查,误诊率仍为5%,这就是为什么在诊断存疑时,比正常溃疡病例更有必要进行或多或少的广泛胃切除术甚至全胃切除术。