Histopathological Study Of Endoscopic Biopsies Of Premalignant And Malignant Lesions Of Upper Gastrointestinal Tract In A Tertiary Care Hospital

Abstract

BACKGROUND: Malignancies of the gastrointestinal tract (GIT) contribute enormously to the overall cancer burden and mortality. Worldwide, these rally among the leading cancers, and constitute about 15-25% of the total cancer burden. Gastrointestinal malignancies, although considered a disease of the elderly, have been on the rise in young due to swiftly changing lifestyles and food habits. Early detection, however, greatly improves the survival rate of patients.

OBJECTIVES

1. To analyze the spectrum of various premalignant and malignant lesions of upper GIT.
2. To analyze the prevalence of these lesions in different age groups and genders.
3. To analyze the site-wise prevalence of these lesions.

METHODOLOGY: The study was conducted in the Department of Pathology, SKIMS for 18 months. Biopsies received at the department were processed and analysed. The tumours were staged as per 8^th AJCC guidelines. Lesions of the oral cavity were excluded.

RESULTS:- Out of 154 cases, the majority (52) were in the age range of 60-70 years followed by 35 cases in the age group of 70-80 years. 96 patients were males and 58 were males. The most common symptom was dyspepsia seen in 39.6% of the cases, followed by dysphagia in 29.2%. and epigastric pain in 16.9%.75 endoscopic biopsies were from the stomach, 58 from esophagus, 13 from GE junction & 8 from the duodenum. Majority of the lesions presented endoscopically as ulceroproliferative, followed by ulceroinfiltrative. Out of 58 ulceroproliferative lesions, 29 were diagnosed as adenocarcinoma on histology & 26 as squamous cell carcinoma. 21 ulceroinfiltrative lesions were diagnosed as adenocarcinoma & 15 as squamous cell carcinoma.8 polypoid lesions were diagnosed as adenocarcinoma and 6 as SCC. 73.1% of adenocarcinomas occurred in males. Among squamous cell carcinomas, 55.6% occurred in females. All 54 SCC cases occurred in the stomach.

CONCLUSION: Endoscopic biopsies can detect changing patterns in the spectrum of lesions besides detecting upper GI mucosal lesions at an early stage especially atrophy, intestinal metaplasia and dysplasia so as to prevent the progress of these lesions to invasive cancer.