Gastric cancer in chronic atrophic gastritis: Associated gastric ulcer adds no further risk

P. A. Testoni, E. Masci, R. Marchi, M. Guslandi, G. Ronchi, A. Tittobello

Research output: Contribution to journalArticlepeer-review


Atrophic gastritis with intestinal metaplasia is generally considered a precancerous lesion. We followed 261 patients with chronic atrophic gastritis and intestinal metaplasia, with and without gastric ulcer, every 12 months for 9 ± 2 years by means of endoscopic and histological examination. In the presence of dysplasia, however, studies were carried out every 6 months in moderate cases, or every 3 months in severe cases. Patients with gastric ulcer received medical therapy for 8 weeks; if healing did not occur, treatment was continued. Only subjects with healed ulcers were admitted to the follow-up. To date, 205 subjects have been included in the study. Over a 10-year period, 16 patients with recurrent gastric ulcer and 12 patients with cancer in situ or in an early stage, were subjected to surgery. One case of advanced cancer was observed. Cancer has been found in five of 95 cases of atrophic gastritis with gastric ulcer (5.2%), and in 7 of 166 cases of atrophic gastritis without gastric ulcer (4.2%). The difference was not statistically significant. Our results confirm that gastric ulcer per se is not a high-risk condition, but it must be considered as an epiphenomenon on a background of epithelial atrophy.

Original languageEnglish
Pages (from-to)295-302
Number of pages8
JournalJournal of Clinical Gastroenterology
Issue number3
Publication statusPublished - 1987


  • Atrophic gastritis
  • Gastric cancer
  • Gastric ulcer
  • Intestinal metaplasia

ASJC Scopus subject areas

  • Gastroenterology


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