Interpretation of Upper Gastrointestinal Tract Mucosal Biopsies – A Tertiary Care Centre Experience
Keywords:
Upper GI, Endoscopy, Biopsy, Inflammatory
Abstract
Background: Endoscopy is one of the initial diagnostic tests performed for the evaluation of upper gastrointestinal (GI) symptoms in clinical practice. Accurate interpretation and confirmation can be achieved by histopathological study of endoscopic biopsies and is one of the bases for planning proper treatment. Methods: Total 200 endoscopic biopsies, 50 from oesophagus, 50 from stomach and 100 from duodenum received in the department of pathology of a tertiary care medical college and hospital, Ahmedabad, Gujarat, India, over a period of two years from patients of all ages and sex with upper GI symptoms were included. Specimens were processed according to standard protocol and then reported by pathologist. The spectrum of histopathological lesions, whether inflammatory, non – neoplastic or neoplastic was evaluated along with the overall frequency, age and sex distribution of various upper gastrointestinal lesions. Result: Out of 200 cases of endoscopic biopsies received, 114 were males and 86 were females (M:F- 1.3:1). Majority were non-neoplastic lesions comprising of 153 (76.5%) cases. Out of 38(19%) malignant cases, oesophagus was the most common site comprising 78.9% and duodenum was the least common site comprising 10.5% of total malignancy. In duodenum 25% cases of celiac disease were also identified. Conclusion: In this prospective study, the commonest site for upper GI endoscopic biopsy was from the duodenum (50%). Overall Inflammatory lesions were more common (76.5%), the predominant sites being stomach (88%) and duodenum (68%). Most common site for malignancy was oesophagus, histological type was Squamous Cell Carcinoma predominantly. Endoscopic biopsy serves as an effective tool for the diagnosis and management of upper gastrointestinal lesions.References
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Retrospective Study. Sch. J. App. Med. Sci. May 2016; 4(5E):1807-1813.
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18. Krishnappa R, Horakerappa MS, Karar A, Mangal G. A study on histopathological spectrum of upper gastrointestinal tract endoscopic biopsies. Int J Med Res Health Sci. 2013; 2(3):418-424
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22. Shepherd NA, Valori RM. Guidance for Endoscopic Biopsy in the Gastrointestinal Tract Frontline. Gastroenterology. 2014; 5(2): 84-87.
2. Suvakovic Z, Bramble MG, Jones R, Wilson G, Idle N, Ryott J. Improving the detection rate of early gastric cancer requires more than open access gastroscopy: a five year study. GUT 1997; 41(3):308–13
3. Barr H. Endoscopic screening for upper gastrointestinal malignancy. In: Westby D, Lombard M, editors. Therapeutic Gastrointestinal Endoscopy. UK: Martin Dunitz Ltd; 2002 :54 – 6
4. Nowshad Khan, Ghulam Shabbir, Muham. Upper Gastrointestinal Endoscopic Assessment of Patients Presenting With Dyspepsia. JPMI 2007; 21(3):212-216.
5. Kreuning J, Osman FTB, Kuiper G, A. M. v.d. Wal, J. Lindeman. Gastric and duodenal mucosa in ‘healthy’ individuals an endoscopic and histopathological study of 50 volunteers. Journal of Clinical Pathology, 1978, 31, 69-77.
6. Afzal S, Ahmad M, Mubarik A, Saaed F, Rafi S, Saleem N, Hussain A. Morphological spectrum of gastric lesions-Endoscopic biopsy findings. Pak Armed force Med J. 2006 june; 56(2):143-9.
7. Oberluber G, Granditsch G, Voselrang H; The histopathology of celiac disease; time for a standardized report scheme for pathologist, European Journal of gastroenterology and hepatology 1999; 11:1195-1194.
8. Aparajita A, Mohanty RC, Sahu AA, Mohanty R, Satpathy PK, Bhuyan T. Histomorphological study of upper GI endoscopic biopsies. Int J Health Sci Res. 2016; 6(12):59-64.
9. Gumber R, Mulay SS. Endoscopic Biopsy Interpretation of Upper Gastrointestinal Pathologies. International Journal Of Scientific Research. 2016 Oct; Vol 5 (10):20-24.
10. Qureshi NA, Hallissey MT, Fielding JW. Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review. BMC Gastroenterology 2007; 7:43.
11. Sacco F, Bruce MG, McMahon BJ, Bruden D. A prospective evaluation of 200 upper endoscopies performed in Alaska native persons. International Journal of Circumpolar Health 2007; 66(2):144-52.
12. Choomsri P, Bumpenboon W, Wasuthit Y, Euanorasetr C, Sumitpradit P, Suwanthunma W. Upper gastrointestinal endoscopy findings in patients presenting with dyspepsia. The Thai journal of Surgery 2010; 31:7-12
13. Gulia SP, Chaudhury M, Noorunnisa N, Balakrishnan CD, Balagurunathan K. Interpretation of Upper Gastro Intestinal Tract Endoscopic Mucosal Biopsies – A Study Conducted in Teaching Hospital In Puducherry, India. Int J Med Health Sci. July 2012; Vol-1(3):17-24.
14. Sheikh BA, Hamdani SM, Malik R. Histopathologicalspectrum of lesions of upper gastrointestinal tract – A study of endoscopic biopsies. Gjmedph 2015; Vol. 4(4):1
15. Memon F, Baloch K, Memon AA. Upper gastrointestinal endoscopic biopsy; morphological spectrum of lesions. Professional Med J 2015; 22(12):1574- 1579.
16. Abilash SC, Kolakkadan H, Gitanjali MM, Shreelakshmidevi S, Balamuruganvelu S. Histopathologic Spectrum of Upper Gastrointestinal Tract Mucosal Biopsies: A
Retrospective Study. Sch. J. App. Med. Sci. May 2016; 4(5E):1807-1813.
17. Rosai J In:Rosai and Ackerman’s Surgical Pathology. 10th ed. Elsevier: Mosby;2011:673-713.
18. Krishnappa R, Horakerappa MS, Karar A, Mangal G. A study on histopathological spectrum of upper gastrointestinal tract endoscopic biopsies. Int J Med Res Health Sci. 2013; 2(3):418-424
19. Zsikla V, Hailemariam S, Baumann M, Mund MT, Schaub N, Meier R, Cathomas G. Increased rate of Helicobacter pylori infection detected by PCR in biopsies with chronic gastritis. Am J Surg Pathol 2006; 30:242–248.
20. Gajalakshmi V, Swaminathan R, Shanta V. An independent survey to assess completeness of Registration: Population based cancer registry, Chennai, India. Asian Pac J Cancer Prev 2001; 2:179 – 83
21. Khandelia R, Saikia M. Histopathologic Spectrum of Upper Gastrointestinal Tract Mucosal Biopsies: A Prospective Study. International Journal of Medical Science and Clinical Inventions. 2017; 4(11): 3314-3316.
22. Shepherd NA, Valori RM. Guidance for Endoscopic Biopsy in the Gastrointestinal Tract Frontline. Gastroenterology. 2014; 5(2): 84-87.
Published
2018-08-27
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