Abstract

 Background: Most of the gastric cancers present in advanced stages whereas early detection and accessible diagnostic adjuncts are of paramount clinical importance for fruitful management. This study aims at ascertaining the clinical, endoscopic and histopathological characteristics of gastric carcer patients who came with the symptoms of peptic ulcer diseases (PUD).  Methods: This retrospective study was conducted from January 2023 to December 2025 at medicine department of TMSS Medical college & Rafatullah Community Hospital (TMC & RCH), Bogura, Bangladesh. Total 150 stomach cancer patients were included; all were rural patients, and the age range was 38 to 80 years. Esophagogastroduodenoscopy (EGD) was done and during the procedure, tissue samples were taken from the suspected lesions for histopathology. Results: Out of 150 histologically confirmed stomach cancer cases, 70.7% (n=106) were males and 29.3% (n=44) were females. The primary presenting symptom was vague dyspepsia (44.80%), followed by cachexia/weight loss (27.58%), palpable epigastric lump (17.20%), and gastric outlet obstruction (10.30%). Distant metastasis was established in 45 patients at baseline. Topographically, lesser curvature was the primary site for malignancies in 68% of cases, followed by the pylorus/antrum (24%). Active Helicobacter pylori infection was confirmed in 53.33%, showing a remarkable link to the intestinal-type adenocarcinoma variant. Endoscopy revealed fungating growth as the most common (41.37%), then infiltrating tumors (29.31%), ulcerative lesions (15.51%), and polypoid variants (13.79%). Histopathologically, poorly differentiated carcinoma was the most frequent architectural pattern (20.68%), while classic diffuse adenocarcinoma and intestinal adenocarcinoma occurred in identical proportions (18.96% each). Conclusion: The prevalence of H. pylori and certain histopathological features underscore the necessity for targeted diagnostic and therapeutic strategies, which may improve clinical understanding, management, and patient outcomes in clinical settings.

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