Endoscopic follow-up of gastric ulcer in a population at intermediate risk for gastric cancer

Objectives: Primary: to assess the necessity of a second en doscopy with a pathology study to confirm the healing of all gas tric ulcers previously diagnosed through endoscopy in a popula tion at intermediate risk for gastric cancer. Secondary : to assess correlation between endoscopic findings and pathology diagnosis. Patients and methods: a prospective analysis of patients di agnosed with gastric ulcer through endoscopy at Hospital General de Ciudad Real (Spain) over three years. We collected demo graphic, clinical, endoscopic, and pathological data for the first and subsequent endoscopies. We collected at least six biopsies ob tained from ulcer margins, and assessed H. pylori infection. Results: Three hundred and two patients were included in this study. H. pylori infection was diagnosed in 173 (57%), and 113 (37%) patients had used NSAIDs. The positive and negative pre dictive value for malignancy of endoscopic diagnosis regarding ul cer fold, base, and margins were 34 and 97%, respectively. Only one patient was diagnosed with a tumor during the second en doscopy. At the end of follow-up, the etiology of the ulcer was considered as peptic in 276 patients; Crohn’s disease-related in one, and neoplastic in 25 patients (21 adenocarcinomas, 4 lym phomas). Conclusions: in an intermediate-risk population for gastric cancer a second endoscopy is not justified for gastric ulcer pa tients when endoscopy and biopsy results do not suggest malig nancy.