Follow-up endoscopic study of gastric mucosal changes secondary to gastric ulcer.

A long-term follow-up gastrocamera photographic study of 481 patients with gastric ulcer was conducted at intervals of 3 weeks to 6 months. It showed that gastric ulcers could remain healed for 2 months to 6 years of observation, yet, recurrence of ulceration occurred in 79% including 18% with multiple occurences. Gastric polyp developed in 8 patients whose initial gastrophotography showed no such lesion in the original study. Furthermore, 7 cancers of the stomach developed at sites away from the initial benign ulcer foci. Six of these cases proved to be mucosal cancer and one was an advanced cancer. In 5 of 7 cases of malignancy, the cancer occurred distal to the initial ulcer foci and anaplastic adenocarcinoma was seen in 3 of these. The others were well differentiated adenocarcinomas. No correlation was found among histopathological type of cancer, depth of malignant invasion, location of the new growth or gastric juice acidity in these 7 cases of malignancy. It is concluded that a thorough and routine gastroscopic examination is indicated for all sorts of gastric disorders whether they are initial or follow-up cases.