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Objective To evaluate endoscopic ultrasonography (EUS) for diagnosis of large gastric folds. Methods EUS was performed in 66 patients with possible large gastric folds which could not be diagnosed by conventional gastroscopy. The characteristics of EUS findings were analyzed, and the EUS results were compared with pathological findings to evaluate the sensitivity, specificity and accuracy of EUS. Results The diagnostic sensitivity, specificity and accuracy of EUS for diffused infiltrated gastric cancer were 92.3%(24/26), 95.1% (39/41) and 95.5% (63/66), respectively, and those for gastric lymphoma were 92. 3% ( 12/13), 96. 1% (49/51) and 92. 4% (61/66), respectively. The accuracy in differential diagnosis of benign and malignant disease was 93.9% (62/66). There were statistical differences between benign and malignant large gastric folds in characteristics of EUS findings, including width of gastric wall, enlargement of muscularis propria and preservation of gastric layer ( P ＜ 0. 05 ). Conclusion EUS is of high accuracy for diagnosis of large gastric folds, especially for diffused infiltrated gastric cancer and gastric lymphoma. Such features as width of gastric wall, the enlargement of muscularis propria and the preservation of gastric layer are important features for differential diagnosis of benign and malignant lesions.
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Objective To investigate the gastroscopic manifestations and pathological diagnosis of large gastric folds.MethodsClinical data of 161 cases with large gastric folds,who were diagnosed by gastroscopy from January 2002 to April 2008,were analyzed.Endoscopic mucosal resection or strip-off biopsy by ultrasonic endoscopy was performed if diagnosis could not be identified using routine biopsy by the gastroscopy.ResultsOf the 161 cases,79 patients had chronic inflammation(49.1%),67 had gastric cancer(41.6%),11 showed malignant lymphoma(6.8%),2 suffered from Menetrier's disease(1.2%),1 had acute inflammation(0.6%),and 1 showed no obvious lesion(0.6%);the rate of Helicobacter pylori infection was 42.2%(68/161),and the positive rate for Helicobacter pylori in patients with gastric cancer was 34.3%(23/67).Endoscopic mucosal resection biopsy was performed on 15(9.3%) of the cases,5 of them had chronic inflammation,5 showed gastric cancer,4 were confirmed with malignant lymphoma,and 1 was diagnosed as having Menetrier disease.The lesion of large gastric folds involved the whole stomach in 10 patients,the gastric fundus in 10,gastric corpus in 86,gastric antrum in 5,both the gastric fundus and corpus in 31,and both the gastric corpus and antrum in 19.All of the 10 cases,who had the whole stomach being invaded,were diagnosed as having gastric cancer.Though both gastric cancer and chronic inflammation showed similar manifestations under gastroscope,the levels of the characteristics were significantly different(Dilatancy poor: ?2=10.093,P=0.001;peristalsis poor: ?2=19.116,P=0.000;gastric cavity narrowing: ?2=18.159,P=0.000;texture stiffness: ?2=54.302,P=0.000;texture brittle: ?2=6.132,P=0.013;erosion: ?2=5.619,P=0.018;and ulcer: ?2=22.743,P=0.000).ConclusionsMost of the patients with large gastric folds are diagnosed as having chronic inflammation,gastric cancer,or malignant lymphoma,while Menetrier disease and acute inflammation seldom occur.The lesion usually involves the gastric corpus.For those who have the whole stomach being invaded,gastric cancer can be revealed.Most of the malignant cases show ulcers,dilatancy poor,and peristalsis poor under a gastroscope.Endoscopic mucosal resection biopsy is effective for identifying the diagnosis of malignant lesions.
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Objective To enrich the knowledge in large gastric folds. Methods We investigated 45 cases of large gastric folds in ten years (1990 - 2001) retrospectively. All cases were examined endo-scopically and histologically. Some of them were examined by endoscopic ultrasonography and upper gastrointestinal barium. Results Of 45 cases with large gastric folds there were 30 cases with gastritis (66. 7% ) , seven with malignant tumors( 15. 6% ) (five with gastric carcinoma and two with malignant lymphoma) , four with Menetrier disease(8. 9% ) , two with systemic lupus erythematosus, one each with Billroth II anastomosis and gastric ulcer. The diseases including tumors, Menetrier disease and connective tissue diseases were located in gastric fundus and/or body . Conclusion The diseases located in upper stomach have more clinical significance. All of endoscopic ultrasonography, upper gastrointestinal barium and endoscopic mucosal resection are helpful in differential diagnosis of the large gastric folds.