Panorama of neoplasms of upper GI tract: a 5 year research study
Keywords:Upper GI tract, Neoplasms, Research, Study
Background: The diseases of the gastrointestinal tract (GIT) are the most common and leading cause of morbidity and mortality than the disorders of any other systems of the body. Gastrointestinal (GI) tract tumors are one of the most common cancers accounting for 11% of all cancers. Among these tumors, upper gastrointestinal tract malignancies are quite aggressive with a dismal prognosis. Malignant tumors are most common than benign. The most common carcinoma of the esophagus is Squamous cell carcinoma (SCC). Incidence of SCC is less than 5 per 100,000 populations in males and 1 per 100,000 populations in females. Gastric cancer was the second most common cancer in the World and 60% of them occurred in developing countries. The most common carcinoma of the Stomach is Adenocarcinoma.
Aim & Objectives: To study the spectrum of neoplastic lesions of the upper gastrointestinal tract by the examination of endoscopic biopsies and surgically resected specimens. To determine the degree of severity of the malignancies by assessing the depth of invasion, Lymph nodal & Omental spread.
Methods: The present study is both retrospective & prospective study for a period of 5 years from January 2007 to December 2011. The sample size includes all the endoscopic biopsies & surgically resected specimens of gastrointestinal tract received at Department of Pathology, S.V. Medical College, Tirupati. The study also obtained clearance from the ethical committee of the institution. The biopsy specimens thus obtained were fixed in 10% buffered neutral formalin. The sections were stained routinely with H & E. Special stains and IHC done wherever necessary.
Results: we have received 120 specimens regarding the upper gastrointestinal system. Among these 120 specimens, 71 specimens were endoscopic biopsies & 49 specimens were surgically resected specimens. Out of 71 Endoscopic biopsies 28 biopsies were malignant among which 2 was esophagus and 26 were stomach. Out of 49 surgically resected specimens 1 was benign and 32 were malignant tumors. Out of 59 neoplasms of stomach there were single cases each of Sub mucosal Lipoma, Malignant lymphoma, GIST & 56 cases of Adenocarcinoma & its variants were noted.
Conclusion: Most of the neoplasms are of stomach (97%). All the neoplasms are malignant except one benign lesion sub mucous lipoma of stomach. Most of the neoplasms of stomach were Adenocarcinoma (96.5%). Both tumors of esophagus were squamous cell carcinoma occurred after 50 years of age.
Tuladhar S; Comparative study of gastric wash cytology and gastric biopsy in various gastric malignancies. Postgraduate Medical Journal of NAMS. Vol 12,November-2;Jul-Dec 2011, 20-23.
Helena Kollarova, Lucie Machova, Dagmar Horakova, Gabriela Janoutova, Vladimir Janout; Epidemiology of Esophageal Cancer – An overview article; Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007,151(1):17–28.
Stanley R. Hamilton, Lauri A. Aaltonen; Pathology and Genetics of Tumors of the Digestive System; World Health Organization Classification of Tumors; 2000.
B. Popescu, C. R. Popescu, Raluca Grigore, Carmen Aurelia Mogoanta, Elena Ionita,C. Moculescu, S. V. G. Bertesteanu; Morphology and morphopathology of hypopharyngo-esophageal cancer; Rom J Morphol Embryol 2012, 53(2):243–248.
Katherine D Crew, Alfred I Neugut; Epidemiology of gastric cancer; World J Gastroenterol 2006 January 21; 12(3): 354-362.
Vinay Kumar, Abul K. Abbas, Nelson Fausto, Jon C. Aster, Robbins and Cotran Pathologic basis of disease, 8th Edition, 763-832.
Stacy Carl-McGrath, Matthias Ebert, et al; Gastric adenocarcinoma: epidemiology, pathology and pathogenesis; Cancer Therapy Vol 5, 877-894, 2007.
Rosai & Ackerman; Surgical pathology - 9th Edition; 615 -872.
K S Henle; History of fiberoptic endoscopy. Gastroenterology 06/ 1980;78(5pt 1):1123-4.
Morrissey JF. The 1982 A/S/G/E distinguished lecture: Gastrointestinal endoscopy-20 years of progress. Gastrointestinal Endoscopy 03/1983; 29(1):53-6.
Basnet RB, Shrestha HG, Dali S, Sayami G,Osti B, Amatya VJ. Present cancer scenario and its changing pattern at T.U. Teaching Hospital, Nepal. JNMA, Souvenir 1997;35:45-51.
R Kalyani, Subhashish Das, M L Harendra Kumar; Spectrum of Gastro - intestinal cancers -- a ten year study; Journal of Indian Medical Association, October 2010, Vol 108(10); 659-662.
Wakhisi J, Patel K, Buziba N, Rotich J. Esophageal cancer in north rift valley of Western Kenya. African Health Sciences. 2005;5(2):157–163.
J Y Ro, CI Park, CJ Kim, Y B Lee; A Study of Gastric Carcinomas among Koreans with special reference to the Pathogenetic relation of Intestinal metaplasia; Yonsei Med J; Vol 19, No 2, 1978; 35-47.
Lizbeth Lopez Carillo, Beatriz Vega Ramos, Roberta Costa Dias, Ramon A Rascon Pacheco; Histological types of Gastric cancer in Mexico; International Journal of Epidemiology, 1997; Vol 26, 1166-1171.
Sambasivaiah K, Ibrarullah M, Reddy MK, Reddy PV, Wagholikar G, Jaiman S, Reddy DG, Sarma KV, Hegde GN; Clinical profile of carcinoma stomach at a tertiary care hospital in south India. Trop Gastroenterol. 2004 Jan Mar; 25(1):21-6.