The relationship between endoscopic findings of gastric ulcer scar and ulcer relapse.

Regenerated mucosal patterns that appeared during the healing of chronic gastric ulcers were observed and assessed in detail by magnifying endoscopes. Three patterns of ulcer scarring were distinguished: Sa with central depression, Sb with a coarse regenerated mucosal pattern, and Sc with a fine mucosal pattern. From a study on the relationship between the depth of ulcer confirmed histologically and the endoscopic findings of the scar, a clear distinction could be made endoscopically between U1-IV scar with a well-demarcated scarring zone, U1-III scar with an unclear boundary, and U1-II scar without a distinct scar area. Scar patterns were also related to ulcer depth. Analysis of the relationship between an ulcer relapse and the scar pattern demonstrated that the ulcer relapse rate over a 2-year follow-up period was 84% in Sa, 33% in Sb, and 0% in Sc.