[Nontargeted biopsy during gastroscopy].
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In 478 patients with gastric ulcer 121 times (25.3%) secondary pathological findings were found in the oesophagus, in the stomach and the duodenum. Erosions, scars and polyps were most frequently to be seen. But concomitant pathological findings with high clinical importance, such as carcinoma of the stomach and the oesophagus as well as varicose veins of the oesophagus, could also be established. The demand is of importance to search intensively for further lesions also after diagnosis of the ulcer. From this resulted conclusions, such as operation in carcinoma, continuation of the diagnostics in varicose veins of the oesophagus or control in polyps.
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Simultaneous measurement of plasma and gastric immunoreactive carcinoembryonic antigen (CEA) was performed in 108 patients undergoing upper gastrointestinal endoscopy. Gastric immunoreactive CEA was more sensitive than plasma CEA (92% vs. 65% positive) in patients with gastric cancer. In cancer patients gastric CEA was significantly higher than in all other patient groups. The extent of disease, the histologic type of adenocarcinoma, and the macroscopic appearance of the tumor had no influence on gastric CEA results. Gastric CEA was elevated in 44% of patients with gastritis and 26% of patients with benign gastric ulcers, but was never elevated in patients with no gastric pathology. In patients with benign disorders, elevated gastric CEA was significantly correlated with atrophic gastritis especially of moderate or severe degrees. Elevated levels persisted in patients with pernicious anemia and severe atrophic gastritis but returned to normal with healing of benign gastric ulcers. Simultaneous measurement of gastric total protein or potassium content was necessary to correct for variations in sample collection. We conclude that gastric CEA was not useful for distinguishing between benign and malignant lesions but should be studied further for screening high risk patients, for identifying and following patients with "premalignant" conditions, and for following cancer patients before and after surgery and/or chemotherapy.
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