© 2002 by Gut
DISCUSSION I
Discussion I
Keywords: dyspepsia; gastro-oesophageal reflux disease; endoscopy; Helicobacter pylori; heartburn
Question: Professor Tytgat, you mentioned a study from the UK in which patients with gastric cancer had previously undergone endoscopy but in whom an early lesion was missed. Which study was this and where was it published?
Professor Tytgat: The study was published in Gut in 1997.1 The study looked at a large group of patients with gastric cancer. Approximately 70% of these patients had peptic symptoms prior to the diagnosis of early malignancy, and a substantial proportion of these had undergone endoscopy prior to detecting overt malignancy. Undoubtedly, at the time of endoscopy, the lesion must have been present. This is the very first paper to indicate that we probably miss a lot on endoscopy—at least that is the message that I took from the paper.
Question: Why were the early malignancies missed? Could it be due to the fact that not enough biopsies were taken?
Professor Tytgat: These
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