Comparison and Evaluation of the Combine Alcian Blue -PAS and Hematoxylin and Eosin in the Detection of Gastric Intestinal Metaplasia among Sudanese Patients with Chronic Gastritis

Abstract

Gastric cancer is the fifth most common cancer and the second most frequent cause of cancer death worldwide, gastric cancer remains a major cause of mortality and morbidity worldwide. Gastric intestinal metaplasia, an intermediate step in gastric carcinogenesis, is generally regarded as a pre-malignant lesion. Gastric intestinal metaplasia is a precancerous modification of the mucosa of the stomach with intestinal epithelium and is associated with an expanded danger of dysplasia and cancer. The study aimed to compare and evaluate the combined alcian blue –PAS and Hematoxylin and Eosin, in the detection of gastric intestinal metaplasia among Sudanese patients with chronic gastritis. Two hundred tissue sections were cut from 100 formalin-fixed paraffinembedded Blocks (n=100) were collected from patients who attended El-mek Nimir University Hospital & Specialized Centers at Shendi locality- River Nile State between June to December 2021, and thereafter processed and examined histopathologically, all blocks were cut into (3 micrometers) by using SLEE-MAINZ,-CUT4060 microtome. And spread in a water bath then put in coated glass slides, then all sections deparaffinized in xylene and rehydrated through descending grade of alcohols, then water.100 tissue sections were stained by hematoxylin and eosin technique and 100 were stained by combined alcian blue –PAS stain technique. Combine Alcian blue & PAS is more detected the Gastric Intestinal Metaplasia compared to H& E was observed among chronic gastritis patients in Combine Alcian blue & PAS technique positive in 19 (19%) cases and negative in 81(81%) , by routine H& E is positive in 11 (11%) , cases and negative in 89 (89%) cases and the overall prevalence of gastric intestinal Metaplasia was 19%, from which 12 (63.1%) among female, and 7 (36.8%) were male and the age they classify into three groups A (10-40 years) group B (41-70 years) group C (71-100 years) the result of GIM positive rate was found 2 (6.6) , 10(23.3%) , 7 (25.9%) respectively. On the other hand, the sensitivity of H& E in the detection of (GIM) was 70.3 % and specificity was 100%. The study concluded that combining Alcian blue & PAS is more detected and sensitive in the detection of gastric intestinal metaplasia among Sudanese Patients with chronic gastritis compared to H& E. Additionally, The most positive rate was among females and within the age group (41-70) years old was observed. This may direct the clinicians and researchers to it could be better to use combined Alcian blue & PAS in diagnosing Gastric Intestinal Metaplasia and look for more information about the detection of gastric intestinal metaplasia.