The clinicopathological features of lower gastrointestinal tract endoscopic biopsies in Benin City, Nigeria

Abstract

Background: Despite the increasing incidence of colorectal cancer in Nigeria, there is no established colorectal screening program in Nigeria and only a few studies have been done on the pathologic features of colonoscopic biopsies in Nigeria. Materials and Methods: The lower gastrointestinal tract biopsy specimens were assessed in the histopathology surgical day books. The demographic information on the age and sex and the clinical information, presenting complaints and endoscopic findings were obtained from the original request cards. All of the archival slides were retrieved and reviewed with the diagnosis confirmed. Also, all available formalin fixed and paraffin embedded tissue blocks of lower gastrointestinal colonoscopic biopsies were sectioned at 3-5μm and stained with haematoxylin and eosin. Each lesion was diagnosed based on specific pathologic findings, clinical history and endoscopic findings as a guide. Neoplastic lesions were classified using the World Health Organization classification (2010]. Study Design: The study aims to describe the common lesions diagnosed on lower gastrointestinal (GI) endoscopy. The clinical history, endoscopic findings, slides, and paraffin-embedded blocks of all endoscopic biopsies of the lower GI tract seen from 2008 to 2012 were studied, and data obtained were analyzed using the SPSS version 16 software. Results: Two hundred and forty-nine specimens were studied. Fifty-seven (22.9%) of these biopsies were normal colonic mucosa and 192 (77.1%) of these biopsies had remarkable pathologies. The most common clinical indication for colonoscopy in this study was hematochezia and over half of these patients (48.6%) had malignant lesions. The most common lesions seen on endoscopy were polyps which were seen in 18.5% of cases. Seventy (36.5%) of these lesions were malignant, with epithelial cancers 67 (95.7%) being the vast majority. Thirty-five (18.2%) of the lesions were benign neoplastic lesions, 52 (27.1%) were inflammatory lesions, 18 (9.4%) were inflammatory bowel disease, 10 (5.2%) were hyperplastic polyps, and 7 (3.6%) were vascular lesions. Conclusion: A wide spectrum of lesions was diagnosed in this study with the predominant lesion diagnosed being malignant neoplastic lesions. The most common clinical indication for endoscopy was hematochezia with over half of these patients having a malignant lesion.