Importance of ulcer size and localization observed at endoscopy in differential diagnosis of gastric ulcers
Ayşe Kefeli 1 * , Abdullah Özgür Yeniova, Yaşar Nazlıgül, Metin Küçükazman, Muhammed Saçıkara, Zeliha Asiltürk, Ayla Tezer, Gülçin Şimşek
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1 Keçiören Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği Ankara, Turkey* Corresponding Author


Objectives: The malign lesions of stomach may be ulcerative. Today, the follow-up periods for patients with gastric ulcer (GU) has not been clearly defined. The aim of this study was to assess the significance of ulcer size and location in differential diagnosis of GUs at endoscopy.
Materials and methods: Data were retrospectively collected from the records of gastrointestinal endoscopy unit and pathology laboratory of our hospital between August 2008 and October 2010. We evaluated the demographic, endoscopic and histopathological features of the patients with GU. ROC curve analysis was performed for determining cut-off diameter differing malign ulcer from benign ulcer during gastroscopy.
Results: A total of 161 patients (81 males, 80 females) with gastric ulcer were included. Twenty-seven patients had malign ulcer and 134 had benign ulcer. Mean ages of groups of malign and benign ulcer were 66.4 ± 13.8 and 56.7 ± 17 years, respectively (p<0.05). Ulcer locations were angulus and antrum in 48% of the patients with malign ulcer and in 86% of with benign ulcer. Mean ulcer diameters were 21.1 ± 12.4 mm and 8.3 ± 6.2 mm, for malign and benign ulcers respectively (p<0.05). Cut-off diameter of gastric ulcers for differing malign from benign was 11 mm. Sensitivity and specifity of this value was 88.9% and 88.8%, respectively.
Conclusions: Although, the site of the ulcer cannot be taken as indicative of its nature, ulcer size may help for predicting ulcer nature. Malignant ulcers tended to be larger (≥11 mm). The repetition of endoscopy may be delayed until the end of treatment in small ulcers (<11 cm).


This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Research Article

J Clin Exp Invest, Volume 2, Issue 3, September 2011, 273-276

Publication date: 13 Sep 2011

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