Diagnosis of ulcerous early cancer of the stomach

: Early cancer of the stomach most frequently presents as an ulcer. The latter lesions were observed in 107 out of 138 (77.5%) patients with different types of early gastric cancer. Ulcers were correctly diagnosed by standard methods of X-ray examination in 90.6% of cases, while by endoscopy-in nearly 100%. However, malignant transformation of ulcer was reliably established by the said procedures in as low as 9.1 and 22.2%, respectively. The nature of ulcer was identified by histo-cytologic examination of bioptate which confirmed the diagnosis of ulcerated early cancer in 94.4%. Failure to detect cancer makes the case for repeat (at least 3) biopsies. Cases of cancer-negative ulcer should be followed-up.