Title: Histomorphological spectrum of gastric lesion in endoscopic biopsies: An institutional experience
Authors: Dr Saroj Meshram, Dr Sanjay Parate, Dr Shilpa Tathe, Dr Archana Randale, Dr Milind Bhatkule
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.18
Abstract
Introduction: Gastric disorders are one of the most commonly encountered problems in clinical practices. The definitive diagnosis of gastric disorders rest on histopathological confirmation and is one of the gold standard investigation for gastric lesions.
Materials and Methods: This prospective observational study of two years duration was carried out to determine the histopathological spectrum of gastric lesion in endoscopic biopsies at tertiary care center. Total 272 consecutive gastric biopsies were included in study.
Results: Neoplastic lesions accounted for 64.8% of cases outnumbering non-neoplastic lesions which constituted about 36.15% of cases. Chronic gastritis (68.09%) was the commonest non-neoplastic lesion. Helicobacter pylori positivity was seen in 61% cases of chronic gastritis. In the neoplastic category Adenocarcinoma of intestinal type was the commonest malignancy (98.7%) followed by signet ring carcinoma accounting for 20.13% of cases.
Conclusion: Upper GI endoscopy with biopsy helps in the evaluation of chronic gastritis ,detection of Helicobacter pylori, early diagnosis of cancer risk factors especially atrophy, intestinal Metaplasia and dysplasia ,distinguishes benign from malignant gastric ulcers and different types of gastric tumors thus providing wide range of treatment options and possible cure.
Keywords: Upper GI endoscopy, Gastric biopsy, Histomorphological spectrum.
References
- Blackstone MO. Endoscopic Interpretation. Normal and pathologic appearances of the Gastrointestinal tract. Raven Press New York 1984; 1: 13-15.
- Sipponen P, Stolte M. Clinical impact of routine biopsies of the gastric antrum and body. Endoscopy 1997; 29: 671-8.
- Sipponen P. Update on the pathologic approach to the diagnosis of gastritis, gastric atrophy and Helicobacter pylori and its sequelae. J Clin Gastroenterol 2001; 32: 196-202.
- Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics 2005. CA Cancer J Clin 2005; 55: 74-108.
- Rosia J In Rosia and Akermans Surgical Pathology.9 ed.St Louis; Mosby,2004,648-711.
- Lauwers GY, Carneiro F, Graham DY. Gastric carcinoma. In: Bowman FT, Carneiro F, Hruban RH, eds. Classification of Tumours of the Digestive System. Lyon: IARC;2010.
- Suvakovic Z, Bramble MG, Jones R, Wilson G, Idle N, Ryott J, et al. Improving the detection rate of early gastric cancer requires more than open access gastroscopy: a five year study. Gut 1997; 41 (3): 308 – 313.
- Pasricha PJ – Gastrointestinal Endoscopy. Lee Goldman J, Clande Bennett. In. Cecil Textbook of Medicine W B Saunders 2000; 21: 649-650.
- Barr H. Endoscopic screening for upper gastrointestinal malignancy. Westaby D, Lombard M. In: Therapeutic Gastrointestinal Endoscopy. Martin Dunitz Ltd (UK) 2002; 54-56.
- Dominis M, Dzebro S, Gasparov S, Buljevac M, Colic-Cvrlje V, Banic M et al. Morphology of gastritis and Helicobacter pylori infection. Lijec Vjesn 2002; 124: 36 – 42.
- Genta R, Graham D, Kihira K, Takimoto T, Saifuku K, et al. Comparison of biopsy sites for the histopathological diagnosis of H.phlori: A topographic study of H.pylori density and distribution. Gastrontest Endosc 1994; 40: 342.
- Neuget AI . Epidemiology of gastric cancer. Semin Oncol 1996;23:281.
- Gulia SP, Chaudhary M, Noorunissa N,CD Balakrishna CD Balagurunathan K. Interpretation of upper gastrointestinal tract mucosal biopsies. A study conducted in tertiary hospital in Puducherry. India..Int J Med Health Sci; July 2012,,3;17-24
- Prasaad PR, Rao B. Histopathological spectrum of gastrointestinal lesions –an experience in a tertiary care centre in south india.Int J Res Med Sci ,2016;4(8);3407-12
- Islam SMJ, Ali SM, Ahmed S, Afroz RD, Chowdhary R, Huda H.JAFMC Bangladesh 2009..5(1):21-4