Histopathological Spectrum of Endoscopic Gastrointestinal Biopsies: An Experience from a Tertiary Care Centre, Uttarakhand, India

Abstract

Introduction: The Gastrointestinal Tract (GIT) is the site of numerous pathological lesions from inflammatory to malignant. Endoscopic biopsy plays an important role in detection of early- stage cancers and precursor lesions. It also aids in determining the extent of disease, monitoring response to therapy and for early detection of complications. However, histopathological evaluation serves as gold standard for diagnosis and aids the clinician in deciding further management. Aim: To determine the histopathological spectrum of gastrointestinal lesions and assess the frequency of benign and malignant tumours in GIT in a tertiary care center in North India. Materials and Methods: It was a retrospective study in which all endoscopic gastrointestinal biopsies received in Department of Pathology at Shri Guru Ram Rai Institute of Medical and Health Sciences from January 2015 to December 2017 were retrieved. The lesions from oropharynx, oesophagus, stomach, small intestine, large intestine, rectum and anal canal were categorised as neoplastic (further divided as benign and malignant) and non neoplastic. The results were tabulated and expressed as frequencies and percentages. Results: Of the 867 cases, 582 were males and 285 were females with a male to female ratio of 2.1:1. The most common age group was sixth decade with a mean age of 53.8 years. Out of a total of 7782 specimens received, 867 (11.1%) were endoscopic gastrointestinal biopsies. Among all the biopsies evaluated, 116 (13.4%) were from oropharynx, 55 (6.3%) oesophageal, 97 (11.2%) from stomach and Gastro-Oesophageal (GE) junction, 138 (15.9%) small intestinal and 461 (53.2%) from colorectum and anal canal. Out of 867 biopsies, 670 (77.3%) were classified as non neoplastic and 197 (22.7%) were neoplastic. Incidence of malignancy was highest in gastric (29%) and oropharyngeal (28.4%) biopsies while it was least in small intestinal biopsies (4.3%). Conclusion: In the current study, squamous cell carcinoma and ulcerative colitis were the most prevalent neoplastic and non neoplastic lesions, respectively. It is advisable to interpret and correlate endoscopic findings with histopathology to arrive at a final diagnosis and aid the clinician for further management.