ANALYSIS OF HISTOPATHOLOGICAL SPECTRUM OF ENDOSCOPIC GASTRO-OESOPHAGEAL BIOPSIES

Abstract

Background: The European Society of Gastrointestinal Endoscopy (ESGE) guidelines advocate an initial diagnostic approach that emphasizes understanding the medical history and symptomatology alongside conducting a thorough physical examination. The flexible fibre optic endoscope has drastically improved the ability to observe the upper gastrointestinal tract and colon directly, significantly enhancing the diagnostic and therapeutic approaches to tumours and gastrointestinal bleeding.

Aim: The present study attempts to correlate the clinical signs and symptoms with histopathological findings of patients undergoing gastroesophageal endoscopy.

Materials and methods: Histopathological test requisition forms and paraffin blocks of gastroesophageal biopsies done at a tertiary care centre were collected from February 2022 to May 2023. The H & E sections of all 160 cases with relevant clinical history and endoscopic investigations were studied. Of the 160 cases, 98 were collected retrospectively and 62 prospectively. Observations were noted down to be further statistically analyzed.

Results: 160 endoscopy-guided gastroesophageal biopsies were received during the study period. The most affected age group was 51-70 years, predominately male. Stomach was the most common biopsy site, and epigastric pain was the most common complaint. Oesophageal biopsies and biopsies at the gastroesophageal junction showed that neoplastic lesions were predominant, while biopsies from the stomach showed a predominance of non-neoplastic lesions. The most common oesophageal lesion and lesion at the gastroesophageal junction was squamous cell carcinoma, while adenocarcinoma was predominantly encountered in gastric biopsies. Among oesophageal lesions, only one case of achalasia cardia was identified. In two cases (8.3%) from the endoscopic biopsy of the gastric lesion, a gastrointestinal stromal tumour was noted. Immunohistochemistry was done for cases of spindle cell tumours to confirm the diagnosis of gastrointestinal stromal tumours using CD117 and DOG1 markers.

Conclusion: The study found that oesophageal and gastroesophageal junction lesions are more common in males, with neoplastic lesions predominating, while gastric lesions are more frequent in females and are more often non-neoplastic. Alcohol and tobacco use were strongly associated with oesophageal and gastroesophageal junction lesions. Correlating endoscopic findings with clinical history and histopathology is essential for early detection and treatment of gastroesophageal lesions.