Histopathology of gastroesophageal lesions and its correlation with helicobacter pylori and mucin histochemistry

Abstract

Objective: Helicobacter pylori infection and subsequent gastric atrophy and intestinal metaplasia (IM) are postulated to increase incidence of gastroesophageal cancers. Hence, this study was carried out with objective to study histomorphology of gastroesophageal lesions and correlate with H. pylori and mucin histochemistry. Materials and Methods: This is an observational, prospective study on 120 gastroesophageal biopsies for identification of H. pylori and mucin histochemistry for type of metaplasia in addition to routine histopathology. Results: Of 120 gastroesophageal biopsies, 58 were esophageal and 62 gastric. Various esophageal lesions comprised of esophagitis, Barrett's esophagus, dysplasia, and esophageal malignancies. H. pylori were detected in 1, 4, and 1 cases of esophagitis, Barrett's esophagus, and adenosquamous carcinoma, respectively. IM was seen in 2 cases of Barrett's esophagus and one each of adenocarcinoma and adenosquamous carcinoma of esophagus. Gastric pathologies comprised of chronic gastritis, gastric ulcer, hyperplastic polyp, Peutz–Jeghers syndrome, adenocarcinoma, and gastrointestinal stromal tumor. A study for H. pylori and mucin histochemistry revealed statistically significant association between H. pylori and gastric adenocarcinoma, chronic gastritis but not with gastric ulcer. 76.31% and 21.73% cases of adenocarcinoma and gastric nonneoplastic lesions showed IM with statistically significant association with gastric adenocarcinoma particularly intestinal type. Conclusion: Since there is significant role of H. pylori and gastroesophageal malignancies histopathology and early detection of the bacilli can help in timely treatment and prevention of gastroesophageal malignancy.