IJCRR - 7(16), August, 2015
Pages: 78-85
CLINICO HISTOPATHOLOGICAL STUDY OF UPPER GASTROINTESTINAL TRACT ENDOSCOPIC BIOPSIES
Author: Syed Imtiyaz Hussain, Ruby Reshi, Gulshan Akhter, Ambreen Beigh
Category: Healthcare
[Download PDF]
Abstract:
Background: Upper gastrointestinal tract is an important site for wide variety of lesions especially malignant tumors. Endoscopy in combination with endoscopic biopsy plays an important role in the diagnosis of upper gastrointestinal tract neoplasms and therefore aids in their early management.
Aim: To study the histopathology of upper Gastrointestinal endoscopic biopsies and correlate them with clinical presentation, age, sex and to find the density of Helicobacter pylori in gastritis, gastric ulcers and duodenal ulcers.
Methodology: A two and a half year observational study was carried out on 132 upper Gastrointestinal endoscopic biopsies. Endoscopic upper Gastrointestinal biopsies were fixed in 10% formalin overnight before processing. Routine Hematoxylin and Eosin stain and a special stain Giemsa was done to detect H. pylori.
Results: Out of total 132 upper Gastrointestinal endoscopic biopsies, 37 were from esophagus, 13 from Gastrointestinal junction, 75 from stomach and 7 from Duodenum. Squamous cell carcinoma was more common in esophagus (89%), adenocarcinoma in Gastrointestinal junction (61.5%) and Gastritis in 56% of patients. Dysphagia was common symptom in patients
of Squamous cell carcinoma (100%), epigastric pain in patients of adenocarcinoma (42.9%), dyspepsia in gastritis patients (71.4%). Squamous cell carcinoma, adenocarcinoma and gastritis was more common in the age group of 41-60 years with male predominance (66.7%, 84.6% and 69% respectively). Helicobacter pylori gastritis was present in 32 cases (76.1%) while Helicibacter pylori negative gastritis was present in 10 cases (23.8%). Two duodenal ulcer cases were Helicobacter pylori positive
(100%) and one gastric ulcer case was Helicobacter pylori positive (33.3%).
Conclusion: The endoscopic biopsy not only permits exact diagnosis of specific entity but also provide an opportunity to see H. pylori status and plans for specific medical or surgical therapy. However histopathological study detects mucosal lesions at an early stage especially atrophy, intestinal metaplasia and dysplasia as to prevent progress of these lesions to invasive cancer.
Keywords: Endoscopic biopsies, Upper gastrointestinal tract, Squamous cell carcinoma, Adenocarcinoma
Citation:
Syed Imtiyaz Hussain, Ruby Reshi, Gulshan Akhter, Ambreen Beigh. CLINICO HISTOPATHOLOGICAL STUDY OF UPPER GASTROINTESTINAL TRACT ENDOSCOPIC BIOPSIES International Journal of Current Research and Review. 7(16), August, 78-85
References:
1. Zhang XF, Huang CM, Lu HS, Wu XY, Wang C, Guang GX et al. Surgical treatment and prognosis of gastric cancer in 2613 patients. World J Gastroenterol 2004; 10: 3405-3408.
2. EnzingerPC, Mayer RJ. Esophageal cancer. N Engl J Med 2003; 349: 2241-52.
3. National Cancer Registry Programme. First All India Report 2001-2002. Vol. 1. Indian Council of Medical Research Bangalore, India. April 2004.
4. Evan’s D. MD, Craven JL, Murphy F and Clearly BK. Comparison of early gastric cancer in Britain and Japan. Gut 1978; 19: 1-9.
5. D.R. Saha. Studies on Helicobacter pylori: National Institute of Cholera and Enteric Diseases. Annual Report 2004-2005.
6. Singh V, Trikha B, Vaiphei K, Nain CK et al. Helicobacter pylori: Evidence forspouse-to-spouse transmission. Journal of Gastroenterol. Hepatol. 1999; 14: 519-522.
7. C.S Goodwin, JA Armstrong, BJ Marshall. Campylobacter pyloridis, gastritisand peptic ulceration. J Clinic Pathol 1986; 39: 353-365.
8. Kobayashi O, Eishi Y, Ohkusa T et al. Gastric mucosal density of Helicobacter pyloriestimated by real-time PCR compared with results of urea breath test and histologicalgrading. J Med Microbiol 2002; 51: 305-11.
9. Ozturk S, Serinsoz E, Kuzu I et al. The Sydney System in the assessment of gastritis:Inter-observer agreement. The Turkish Journal of Gastroenterology 2001; 12: 36-9.
10. Shennak MM, Tarawneh MS, Al-Sheik.Upper gastrointestinal diseases in symptomatic Jordanians: A prospectiveendoscopic study. Ann Saudi Med 1997; 17(4): 471-74.
11. Paymaster JC, Sanghvi LD, Ganghadaran P. Cancer of gastrointestinal tract in western India. Cancer 1968; 21: 279-87.
12. Sons HU, Borchard F. Cancer of the distal esophagus and cardia: incidence, tumorous infiltration, and metastatic spread. Ann Surg. 1986; 203: 188–195.
13. Wang J, Noffsinger A, Stemmermann G, Fenoglio-Preiser C. Esophageal squamous cell carcinomas arising in patients from a high-risk area of north China lack an association with EpsteinBarr Virus. Cancer Epidemiology Biomarkers and Prevention 1999 1999; 8(12): 1111-4.
14. Ahamed Mohammed Afroz, Bharathi Muniyappa. Histopathological study of neoplastic lesions of upper gastro intestinal tract-by endoscopic biopsy. Thesis submitted to Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore, April2012.
15. Devi Leena KR and Suvarna N. Pattern of gastrointestinal tumours in north Kerala. Indian J of Cancer 1980; 17: 159-163.
16. Durrani AA, Yaqoob N, Abbasi S, SiddiqM, Moin S. Pattern of upper gastrointestinal malignancies in northern Punjab. Pak J Med Sci 2009; 25(2): 302-307.
17. Sujata Metan, P.V. Patil. Upper Gastrointestinal Tract Endoscopic Biopsies – A Histopathological Study. A One Year Cross Sectional Study. Thesis Submitted to KLE’S Dr. Prabhakar Kore Hospital, Belgaum, KLE University, Belgaum, Karnataka. 2011.
18. Vidyavathi K, Harendra Kumar ML, Lakshmana Kumar YC. Correlation of endoscopic brush cytology with biopsy in diagnosis of upper gastrointestinal neoplasms. Indian J Pathol Microbiol 2008; 51: 489-92.
19. Khan MI, Baqai MT, Bukhari M, Hashmi RI. Gastric Carcinoma: 5 Years survival after gastric surgery. 2005; Vol. 55; No. 4: pages 158-60.
20. Kumar MK and Ramachandran P. Carcinoma esophagus in north Kerala. The Indian J of Cancer 1973; Jun: 183-187.
21. Gadour MO and Ayoola EA. The frequency of upper gastrointestinal malignancy in Gizan. Saudi J Gastroenterol 2004; 10(1): 16-21.
22. Sivangamani K, Reddy B, Changal R. Carcinoma of the stomach – A study of 200 cases. The Indian J of Cancer 1974 Dec: 437- 443.
23. E.J. Kuipers, A. M. Uyterlinde, A.S. Pena, R. Roosendaal et al. Long-term sequelae of Helicobacter pylori gastritis: The Lancet 1995; 345: 1525-1528.
24. Ohkuma K, Okada M, Murayama H, Seo M, Maeda K, Kanda M, Okabe N. Association of Helicobacter pylori infection with atrophic gastritis and intestinal metaplasia. J Gastroenterol Hepatol. 2000 Oct; 15(10): 1105-12.
25. Rajesh Kumar, G. Bano, B. Kapoor, Sunil Sharma et al. Clinical Profile in H. pylori Positive Patients in Jammu: JK Science 2006; 8(3): 148-150.
26. M E Craanen, W Dekker, P Blok, J Ferwerda, G N J Tytgat. Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the gastric antrum. Gut, 1992; 33: 16-20
27. M. Rugge, F.DI. Mario, M. Cassaro, R. Baffa et al. Pathology of the gastric antrum and body associated with Helicobacter pylori infection in non-ulcerous patients: is the bacterium a promoter of intestinal metaplasia? Histopathology 1993; 22: 9-15.
28. A. Oksanen, P Sipponen, R Karttunen, A Miettinen et al. Atrophic gastritis and Helicobacter pylori infection in outpatients referred for gastroscopy: Gut 2000; 46: 460-463.
|