Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 7)

Title

Authors:
Branka Roganović*†, Nenad Perišić*‡, Ana Roganović§

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 Background/Aim. Gastric ulcer may be benign or malig-nant. In terms of therapy and patient’s prognosis early detec-tion of malignancy is very important. The aim of this study was to assess the usefulness of endoscopic ultrasound (EUS) in differentiation between benign and malignant gastric ulcer. Methods. A prospective study included 20 consecutive adult patients with malignant gastric ulceration and 20 consecutive adult patients with benign gastric ulceration. All the patients underwent EUS. A total of 6 parameters were analyzed: ulcer width, ulcer depth, the thickness of the gastric wall along the edge of ulceration (T0), the thickness of the gastric wall 2 cm from the edge of ulceration (T2), loss of layering structure of the gastric wall, and the presence of regional lymph nodes. EUS criteria for malignancy and a point-score of malignancy were defined. The critical value of total point-score was also calculated showing the best reliability parameters. Results. There are 4 criteria for malignancy of gastric ulceration: T0 > 10 mm, T2 > 5 mm, EUS visualization of at least one lymph node, loss of layering structure of the gastric wall. Further-more, T2 > 5 mm was the only EUS independent predictor of ulcer malignancy. The total point score of ≥ 4 was the cut-off point-score value which gave the best reliability parameters in the assessment of malignant ulcers: sensitivity of 70%, speci-ficity of 95%, positive predictive value of 93.3%, negative predictive value of 76% and accuracy of 82.5%. Conclusion. According to the results obtained in this study, we can con-clude that EUS is usefull in differentiation between benign and malignant gastric ulcer.