Barnali Maiti, Shubham Bhattacharya, Asitava Deb Roy
BACKGROUND Upper gastrointestinal tract (GIT) is one of the most common sites for neoplasms, especially malignant tumours . Endoscopic biopsy examination followed by histopathological assessment is a convenient procedure and current gold standard for accurate objectiv e assessment of patients with symptoms of upper GIT. The indications for upper GIT endoscopic biopsy include evaluation of dyspepsia, odynophagia, gastroesophageal reflux disease (GERD), peptic ulcer disease and its complications, abdominal pain, gastric a nd oesophageal growth. Efficient endoscopic findings also help the pathologist to reach a correct diagnosis. Helicobacter pylori (H. pylori) is identified as an important a etiologic factor to develop peptic ulcer disease, gastric MALT lymphoma, pre maligna nt and malignant gastric lesions. The diagnosis of H. pylori is done by rapid urease test in the biopsy material and special staining by Giemsa in the histopathology sections. Therefore, the purpose of this study is to determine the occurrence of upper GI malignancies with identification of different morphological spectrum and find out the correlation between H. pylori infection and gastric malignancy MATERIALS AND METHODS Selected su bjects of upper GI symptoms underwent endoscopy with flexible fibre o ptic endoscope and the endoscopic findings were noted. All the biopsy samples were routinely processed and stained with haematoxylin and eosin (H and E) for light microscopic examination. Rapid urease test in biopsy material and Giemsa stain in the tissue sections were done to detect H. pylori in gastric tissue. RESULTS Out of 109 upper GI endoscopic biopsies 45 malignancies were there which involved 12 from oesophagus, 31 from stomach and two from duodenum. Squamous cell carcinoma in oesophagus and intes tinal type of adenocarcinoma in stomach were the commonest findings. H. Pylori were detected in two (6.45%) out of 31cases of gastric carcinomas. CONCLUSION The upper GI diagnostic endoscopy followed by biopsy is a useful tool to diagnose upper GI malig nancy. Although a small number of patients affected by H. pylori gastritis will eventually develop malignancies, early diagnosis of H. pylori gastrit is followed by eradication of the organism with appropriate treatment should be done to prevent the progres sion to metaplasia, dysplasia and carcinoma.
