Histomorphology Of Upper GI Endoscpic Biopsies: A Study In Urban Care Centre
Keywords:
Oesopahgus, Stomach, Duodenum, Non meoplastic, Malignancy
Abstract
Background: Upper gastro intestinal [GI] disorders are one of the most commonly encountered problems in clinical practice. A variety of disorders can affect upper GI mucosa, ranging from dysphagia, GI bleed, dyspepsia to altered bowel habits. For investigating symptoms related to upper gastro intestinal tract, endoscopic surveillance followed by biopsies from the grossly abnormal areas are the standard protocol followed. Upper GI Endoscopy is a simple safe and well tolerated OPD procedure. Differentiating benign and malignant lesions needs histopathological aid. The definitive diagnosis of gastric disorders relies on the histopathological confirmation and is one of the bases for planning proper treatment. The objective of our study was to find the prevalence of various disease entities in upper GI lesions in our areaMethods: This is a cross-sectional study includes 196 specimens from oesophagus, stomach and duodenum for a period of one year 2016-2017. H&E slides were reviewed by panel of pathologists, the datas were compiled and analysed. Result: Among 196 specimens, male predominance was noted among malignant lesions. In malignancies, squamous cell carcinoma moderately differentiated grade was highly predominant. Out of the seven biopsies from the oesophago- gastric [OG] junction, 57% of the cases were non neoplastic. Two cases each of squamous cell carcinoma and adenocarcinoma was diagnosed from the OG junction during our study period. The incidence of duodenal pathology was comparatively less, adenocarcinoma was very less [3.2%] and inflammatory pathologies were more prevalent with female predominance was noted. A case of carcinoid was diagnosed in the duodenum during our study period.Conclusion: We had encountered wide variations of histopathology in the received biopsies and the incidence seen in our study matched those seen in the literatures.References
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27. Kimchi NA, Mindrul V, Broide E, Scapa E. The contribution of endoscopy and biopsy to the diagnosis of periampullary tumors. Endoscopy. 1998; 30(6):538-43.
2. Mustapha SK, Bolori MT, Ajayi NA, Nggada HA, Pindiga UH, Gashau W, Khalil MIA. Endoscopic Findings and The Frequency
of Helicobacter Pylori Among Dyspeptic Patients in North-Eastern Nigeria. Highland Medical Research Journal. 2007; 5: 78-81
3. Shennak MM, Tarawneh MS, Al-Sheik; Uppergastrointestinal diseases in symptomaticJordanians: A prospective endoscopic study.Annals of Saudi Medicine, 1997; 17(4): 471-474.
4. Paymaster JC, Sanghvi LD, Ganghadaran P; Cancer of gastrointestinal tract in western India. Cancer, 1968; 21: 279-287.
5. Zhang HZ, Jin GF, Shen HB. Epidemiologic differences in esophageal cancerbetween Asian and Western populations. Chin J Cancer 2012;31:281-6
6. Qureshi NA, Hallissey M T, John W;Fielding Outcome of index upper gastrointestinalendoscopy in patients presenting with dysphagia ina tertiary care hospital – A 10 years review. BMC Gastroenterology, 2007; 7: 43.
7. Bazaz -Malik G, Lal N; Malignant tumors of the digestive tract. A 25 year study. Indian Journal of Pathology and Microbiology, 1989; 32(3): 179-185.
8. Bukhari U, Siyal R, Ahmed F, Memon JH. Oesophageal carcinoma. A reveiw of endoscopic biopsies, Pak J Med Sciences 2009; 25 (5); 845-848.
9. B Ziaian, V Montazeri, R Khazaiee, S Amini,M Karimi, D Mehrabani. Esophageal cancer occurrence in southeastern Iran. J Res Med Sci ,2010 sept-oct:15 (5);290-291
10. Boffeta P, Hashibe M. Alcohol and cancer. Lancet Oncol.2006;7:149–156
11. Kuwano H, Ohno S, Matsuda H, Mori M, Sugimachi K. Serialhistologic evaluation of multiple primary squamous cell carcinomas of the esophagus. Cancer 1988;61:1635
12. Kuwano H, Matsuda H, Matsuoka H, Kai H, Okudaira Y, Sugimachi K. Intra-epithelial carcinoma concomitant with esophageal squamous cell carcinoma. Cancer 1987;59:783
13. Memon F, Baloch K, Memon AA. Upper gastrointestinal endoscopic biopsy; morphological spectrum of lesions. Professional Med J 2015; 22(12): 1574-1579.
14. Wang LD, Yang WC, Zhou Q, Xing Y, Jia YY, Zhao X. Changes in p53 and Waf1p21 expression and cell proliferation in esophageal carcinogenesis. World J Gastroenterol 1997 June 15; 3(2): 87-89.
15. Jawalkar S, and Arakeri U S. Role of Endoscopic Biopsy in Upper Gastrointestinal Diseases. RJPBCS. 2015;6(4):977-983.
16. Kaye PV, Haider SA, Ilyas M, James PD, Soomro I, Faisal W, et al. Barrett’s dysplasia and the Vienna classification: reproducibility, prediction of progression and impact of consensus reporting and p53 immunohistochemistry. Histopathology2009;54:699-712.
17. Kastelein F, Biermann K, Steyerberg EW, Verheij J, Kalisvaart M, Looijenga HJ L, et al. Value of alpha-methylacyl-CoAracemase immunochemistry for predicting neoplastic progression in Barrett’s oesophagus. Histopathology 2013;63:630-639.
18. Mustafa SA, Banday SZ, Bhat MA, Patigaroo AR, Mir AW, Bhau KS. Clinico-Epidemiological Profile of Esophageal Cancer in Kashmir. Int J Sci Stud 2016; 3(11):197-202
19. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2014, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2014/, based on November 2016 SEER data submission, posted to the SEER web site, April 2017.
20. Chirieac LR, Swisher SG, Correa AM, Ajani JA, Komaki RR, Rashid A, Hamilton SR, Wu TT. Signet-ring cell or mucinous histology after preoperative chemoradiation and survival in patients with esophageal or esophagogastric junction adenocarcinoma. Clin Cancer Res 2005; 11:2229.
21. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006; 24:2137–50.
22. Rashmi K, Horakerappa MS, Karar A, Mangala G. A Study on Histopathological Spectrum of Upper Gastrointestinal Tract Endoscopic Biopsies. Int J Med Res Health Sci. 2013;2 (3):418-424
23. Khandige S; The Conceding of Upper Gastrointestinal Lesion Endoscopic Biopsy: A Bare Minimum For Diagnosis. International Journal of Scientific Research, 2015; 4(2): 264 – 266
24. Kabir MA, Barua R, Masud H, Ahmed DS, Islam MMSU, Karim E et al.Clinical Presentation, Histological Findings and Prevalence of Helicobacter pylori in Patients of Gastric Carcinoma. Faridpur Med. Coll. J. 2011;6(2):78-81.
25. Kato Y, Kitagawa T, Nakamura K. Changes in the histologic types of gastric carcinoma in Japan. Cancer 1981; 48:2084-87
26. Shepherd NA, Valori RM The effective use of gastrointestinal histopathology: guidance for endoscopic biopsy in the gastrointestinal tract Frontline Gastroenterology 2014;5:84-87.
27. Kimchi NA, Mindrul V, Broide E, Scapa E. The contribution of endoscopy and biopsy to the diagnosis of periampullary tumors. Endoscopy. 1998; 30(6):538-43.
Published
2017-12-20
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