Multiple gastric biopsies were performed with a duodenofiberscope in 58 Chinese subjects. All 58 cases had a gastric ulcer crater, demonstrated by endoscopy, or barium meal, or both. Histological sections of the gastric biopsies showed chronic atrophic gastritis in 12 (20.6%), chronic gastritis in 31 (53.4%), and acute-on-chronic gastritis in 11 (19%). Only two cases or 3.4% had normal gastric mucosa, while 54 cases or 93% had some form of chronic gastritis, on the gastric biopsy. The gastritis was associated with intestinal metaplasia in 16 cases (27.6%), while two cases had histological evidence of gastric atypia. No significant difference was found in the mean basal and peak acid outputs among the three groups of gastric ulcer cases with chronic atrophic gastritis, chronic gastritis, and acute-on-chronic gastritis. The high frequency of chronic gastritis (93%) occurring in patients with gastric ulcer in the present series suggests that chronic gastritis may be an important aetiological factor in the pathogenesis of gastric ulceration.
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