Clinical investigation on coexisting of duodenal ulcer and gastric cancer in China

Abstract

The aim of this study was to investigate the prevalence of coexistent duodenal ulcer and gastric cancer in China, then to explore the features of clinical manifestations, endoscopy, pathology and possible pathogenesis. A retrospective analysis has been made on medical records in Remin Hospital, Wuhan University, Hubei Province, China from January 1991 to December 2002. 37 cases of coexistent duodenal ulcer and gastric cancer were found. 24.3% (9/37) had previous history of duodenal ulcer. 81.0% (30/37) of them lack alarm symptoms or signs and 87.1% (27/31) had alleviation in abdominal pain by acid inhibitor. Duodenal ulcer was single in all cases with seven in A1 stage, three in A2 stage, one in H1 stage, one in H2 stage, seven in S1 stage and 18 in S2 stage. 89.2% (33/37) of concurrent gastric cancer were in the corpus and antrum, with 78.1% (29/37) of them belonging to Bormann type II and 87.1% (27/37) being moderately differentiated adenocarcinoma. 83.7% of patients (31/37) had positive rapid urease test. The coexisting gastric cancer in patients with duodenal ulcer is infrequent but not rare. Gastroscopy screening and routine follow-up are necessary for patients with duodenal ulcer. Helicobacter pylori may be important pathogen for it. Helicobacter pylori eradication is recommended in patients with duodenal ulcer to reduce the risk of contaminant gastric cancer.

Risk Factors Associated with Gastric Cancer in Patients with a Duodenal Ulcer

“…However, in a more recent Swedish study, 206 GC cases developed among 24,456 patients with a DU [2]. Moreover, patients with both GC and a DU are not particularly rare and have been previously reported in Korea (4.8%, 6/126) [23], Taiwan (3.6%, 22/604) [24], and China (1.7%, 37/2132) [9]. In this study, 41 of 541 patients with GC (7.6%) had both GC and a current or a past case of DU, a slightly higher ratio than that found in previous studies.…”

“…However, most DUs were at the scar stage (90.2%), which suggests that GC may follow a DU. In previous studies examining GC patients with a DU, most presented with a scar‐stage DU [5,9]. GC is typically a disease of the elderly, whereas DU is a disease of middle age [27].…”

“…Despite the negative association between DU and GC, GC can develop in patients with a DU [2,4]. A recent retrospective case series of 37 patients having both GC and a DU described the clinicopathological characteristics of this condition [9]. However, this retrospective study did not include control cases; thus, it was not able to compare clinicopathological characteristics.…”

Clinical and psychometric validation of the quality of life assessment system for advanced gastric cancer based on traditional Chinese medicine

“…(3) The most common complaints of gastric cancer patients are dysphagia, eating restrictions, reflux, and abdominal pain. (4) How to improve quality of life (QOL) has become the focus of gastric cancer research. Clinical researchers are choosing measures of QOL as primary and secondary outcomes in clinical trials.…”

Duodenal ulcer and gastric cancer; rare association or an indication for a change of policy?

“…Zhao and coauthors (1) from the Department of Gastroenterology, Remin Hospital of Wuhan University, China have carried out a retrospective analysis of patients with coexisting duodenal ulceration and gastric cancer. The aim of this study was to investigate the prevalence of these coexisting diseases found in the population of this large provincial teaching hospital and to discuss the possible pathogenesis of this infrequent coexistence in a developing country with a high incidence of gastric cancer.…”