Mountford R A, Brown P, Salmon P R, Alvarenga C, Neumann C S, Read A E
Gut. 1980 Jan;21(1):9-17. doi: 10.1136/gut.21.1.9.
A retrospective study has been performed of all cases of gastric ulcer diagnosed or investigated within the Endoscopy Unit of the Department of Medicine, Bristol, over a three year period (1974-76). The average length of follow-up was two years. Two hundred and sixty five cases of gastric ulcer were studied of which 37 proved to be malignant (14%). Presenting complaints of anorexia, weight loss, nausea and/or vomiting, and multiple (greater than 3) symptoms, were commoner in the malignant ulcer group. Ulcer site and the presence of coexisting duodenal ulceration were largely unhelpful in deciding the status of an ulcer. Malignant ulcers tended to be large (greater than 1 cm diameter). Radiology was highly unreliable in distinguishing benign from malignant ulcers. Visual inspection at endoscopy was more reliable, but associated with a tendency to over-diagnose malignancy. False positive biopsies were uncommon (two cases). Three cases of clinically unsuspected superficial gastric carcinoma were revealed. Repeated endoscopy and biopsy of all gastric ulcers until they are completely healed is advised.
对布里斯托尔医学部内镜科在三年期间（1974 - 1976年）诊断或检查的所有胃溃疡病例进行了一项回顾性研究。平均随访时间为两年。共研究了265例胃溃疡病例，其中37例被证实为恶性（14%）。恶性溃疡组出现厌食、体重减轻、恶心和/或呕吐以及多种（超过3种）症状的情况更为常见。溃疡部位和并存十二指肠溃疡的情况在很大程度上无助于判断溃疡的状况。恶性溃疡往往较大（直径大于1厘米）。放射学在区分良性和恶性溃疡方面极不可靠。内镜直视检查更可靠，但存在过度诊断恶性肿瘤的倾向。假阳性活检不常见（2例）。发现了3例临床未怀疑的浅表性胃癌。建议对所有胃溃疡进行反复内镜检查和活检，直至完全愈合。
