DIAGNOSIS OF GASTRIC PREPYLORIC AND ANTRAL LESIONS - COMPARISON OF FIBERENDOSCOPY AND GASTRIC BIOPSY WITH RADIOLOGY

  • 1 January 1976
    • journal article
    • research article
    • Vol. 66  (6) , 530-534
Abstract
Fibergastroscopy and direct-vision gastric biopsy were performed in 47 patients who had a prepyloric or antral gastric lesion on Ba meal (single-contrast) examination. Of 27 cases with a radiological diagnosis of prepyloric or antral ulceration, 5 cases (18.5%) had evidence of ulceration, 12 cases (44.4%) had acute or chronic gastritis and 8 cases (29.6%) had normal gastric mucosa on fibergastroscopy. Multiple gastric biopsy confirmed the presence of acute-on-chronic gastritis (ACG), chronic gastritis (CG) and chronic atrophic gastritis (CAG), with or without intestinal metaplasia (IM) or epithelial atypia (Aty), in 24 cases (89%). Normal gastric mucosa was found in 3 cases (11%) and malignancy in none. Of 15 cases with a radiological diagnosis of prepyloric or antral malignancy, only 3 cases (20%) had evidence of adenocarcinoma on endoscopy and biopsy. One case had rounded nodules seen on endoscopy and gastric biopsies showed malignant lymphoma. In 2 cases with endoscopic suspicion of malignancy, gastric biopsies showed ACG in one and CAG in the other. Gastric biopsies showed histological changes of CG (.+-. IM) or CAG (.+-. IM) in 11 cases (73%). In 5 cases with a radiological diagnosis of various prepyloric or antral lesions, endoscopy and biopsy revealed CG (.+-. IM) in all and malignancy in none. Fiberendoscopy and gastric biopsy were superior to the single-contrast Ba meal in the diagnosis of prepyloric or antral gastric lesions. Direct-vision gastric biopsy should be done in all cases, since it increases the diagnostic accuracy of fiberendoscopy.

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