To explore the clinicopathological characteristics of early gastric cancer similar to benign ulcer and the value of gastroscopy in the examination of early gastric cancer.

A total of 34 patients with benign ulcer whose endoscopic morphological changes were similar to benign ulcers were analyzed retrospectively from January 2015 to December 2019 in Xuancheng Central Hospital of Anhui Province.

The clinical manifestations of the 34 patients included 12 cases of upper abdominal pain, 10 cases of acid reflux, 8 cases of anorexia, and 4 cases of belching. There were 19 cases of adenocarcinoma, 10 cases of poorly differentiated carcinoma and 5 cases of signet ring cell carcinoma. The most common sites included gastric antrum in 15 cases, gastric body in 9 cases and gastric angle in 11 cases, and there were no lymph metastasis or distant metastases. Gastroscopic examination showed gastric ulcer and erosive gastritis, 26 cases had suspected early cancer phenotype, and 8 cases were not diagnosed with gastric cancer according to pathological report. The missed diagnosis rate was 23.5%, and the positive rate of the first biopsy was 76.5%.

Early gastric cancer similar to benign ulcer is easy to miss diagnosis. Gastroscopy is an important means for the diagnosis of early gastric cancer and precancerous lesions similar to benign ulcer, but the positive rate of the first biopsy is not high. Auxiliary techniques such as staining, narrow band imaging (NBI), magnification and clinical follow-up can reduce the risk of missed diagnosis of gastric cancer. At the same time, endoscopists' rich experience is very useful for endoscopic diagnosis.