A Clinicopathological Study of Premalignant and Malignant Lesions of Oesophagus- A Cross-sectional Study

Abstract

Introduction: Oesophageal cancer is the sixth leading cause of cancer related mortality and it ranks eighth among all malignancies in the world.There are multiple factors involved in the causation of oesophageal carcinoma. Aim: To study the clinicopathological features of premalignant and malignant lesions of oesophagus including age, sex, risk factors, tumour location, histological type, grade and stage. Materials and Methods: This is a prospective study of premalignant and malignant lesions of oesophagus conducted at Department of Pathology in a tertiary care centre from June 2013 to June 2014. Complete history of the cases including investigations and type of procedure done were obtained. Haematoxylin and Eosin (H&E) stained sections were prepared and cases reported as premalignant and malignant lesions were analysed for histopathological parameters. Results: In the present study, 187 cases were studied, of which, malignant tumors accounted for 177 cases (83.49%) while premalignant lesions were 10 cases (5.34%). The mean age of oesophageal cancer is 56.4 years and that for premalignant lesions is 50.7 years. Overall male predominance was noted. Most of the malignant lesions were located in the middle third of the oesophagus. Most common histological type was squamous cell carcinoma (SCC) (89.27%) followed by Adenocarcinoma (9.6%) and Neuroendocrine Carcinoma (NEC) (1.13%). The most common macroscopic type was ulcerative type (50.8%). Most of the cases presented in stage IIA (74%). Lymph node involvement was present in 25.92% of cases of SCC and 33.33% of cases of adenocarcinoma. Conclusion: In the present study, SCC was the commonest histological type with peak incidence in 51-60 years. Dysphagia was the most common clinical complaint with tobacco being the major risk factor. Esophageal carcinoma was quite common in this region. However majority of the patients presented at advanced stage due to lack of awareness and delayed symptoms causing major challenge in management. Hence, thorough investigations including histopathological examination is mandatory especially in older patients to rule out carcinoma oesophagus at the earliest, as the prognosis highly depends on histological type, grade and stage.