Kavita Kumari

Abstract

Introduction: Lesion of the gastrointestinal tract is a very common condition encountered in medical science. An endoscopic biopsy is a favourable tool for early diagnosis and management of these conditions. The aim of the work is to study the histopathological spectrum of gastrointestinal endoscopic biopsy. Materials and Methods: In a prospective study of 500 biopsies, Formalin-fixed tissue was processed and stained with Hematoxylin-Eosin stain and studied under the microscope. Result: A wide spectrum of neoplastic and non-neoplastic lesions was noted with male preponderance in most of the gastrointestinal tract. The commonest age group was 6th decades of life. Mean age being 51.83years. Predominant sample collected was from stomach accounting for 36.6% of total gastrointestinal biopsies. The ratio between non-malignant: malignant lesion was 2.7:1. Majority of the malignancy was Adenocarcinoma seen in 71 out of 135 cases closely followed by Squamous cell carcinoma (62/135). Most of the oesophageal malignancy was squamous cell carcinoma whereas adenocarcinoma was common in rest of the gastrointestinal tract. Gastritis was the commonest non-neoplastic lesion. Celiac disease was common in our study. Eight cases of adenomatous polyp identified, four of them showed high-grade dysplasia. Conclusion: Celiac disease and inflammatory bowel disease need further studies as there were many overlapping features which make a definitive diagnosis difficult. Endoscopy itself is insufficient in the diagnosis and management of gastrointestinal tract disease and biopsy must be performed in all cases of suspected endoscopic finding. Conditions like Barrett’s oesophagus, Celiac disease, Inflammatory Bowel Disease and high-grade dysplasia needs timely intervention to avoid more serious complications. Keywords: Celiac disease, Gastritis, Helicobacter Pylori.

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Abstract

Background: The diseases of the prostate gland are the major cause of morbidity and mortality among adult males worldwide. Prostate cancer is the most common malignant tumour in men over the age of 65 years. The present study was done to evaluate the histomorphological spectrum of malignant lesion of prostate and to establish the correlation between S.PSA (Serum Prostate-Specific Antigen) levels and Gleason’s grade in the Western Himalayan region of India. Materials and Methods: Histopathological examination of 100 prostatic tissue was done. Serum PSA assessed and its values were correlated with Gleason’s grading of prostate cancer. Result: Malignancy was found in 29 per cent of cases. Conventional adenocarcinoma encountered in 96.6 per cent cases. Undifferentiated carcinoma was reported in 3.4 per cent cases. Serum prostate-specific antigens level was increased in 93.1% of malignant cases. More than 10ng/ml was seen in 68.9 per cent cases. Mean S.PSA level in malignancy was 122.9ng/ml. The Commonest Gleason’s score being seven (37.9 percent). Conclusion: This prospective study concluded that there is a higher percentage of prostatic carcinoma in the Western Himalayan region of India. PSA is found to be a sensitive marker for the diagnosis of prostate cancer. With a cut off value 4ng/ml sensitivity was found to be 93.75% and specificity was 46.15%, and there is a positive correlation between Serum PSA level and Gleason’s grading. Mean serum PSA level of moderately and poorly differentiated carcinoma was 32.15ng/ml and 325.3ng/ml respectively. Keywords: Adenocarcinoma, Gleason’s grading, Prostate, Serum PSA level.

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Abstract

Introduction: Worldwide, diseases of prostate gland are responsible for significant morbidity and mortality among adult males. Prostate cancer is the second common cause of cancer related death in men after lung cancer but it can be completely cured if detected in early stage. Aim: To evaluate the histomorphological spectrum of non-neoplastic and neoplastic lesions of prostate and to establish the correlation of histomorphological findings with serum prostate specific antigens levels. Materials and Methods: 1 year Prospective Study was done on 110 patient at Department of Pathology , Indira Gandhi Medical College, Shimla, H.P from 1st July 14 to 30th June 15. Unwilling patient, inadequate biopsies and patient with metastatic carcinoma to prostate were excluded from study. Paraffin embedded sections were stained with routine haematoxylin and eosin stain. The PSA levels were estimated in biochemistry department using automated Chemiluminescence method on Beckman Coulter Access –II System. These values were correlated with histopathological diagnosis. Result: With 63.3%, benign prostatic hyperplasia was the most common lesion followed by Malignancy in 29.1% and prostatic intraepithelial neoplasia in 7.3% of total cases. Serum prostate specific antigens level was increased in 65.5% cases. Mean serum prostate specific antigens value of benign prostatic hyperplasia with and without inflammation is and10.9ng/ml and9.8ng/ml respectively. Mean serum prostate specific antigens value is 18.9 ng/ml in Low Grade and78.5 ng/ml in high grade prostatic intraepithelial neoplasm. Mean serum prostate specific antigen in malignancy was 101.2ng/ml antigen in. Conclusion: On statistical analysis PSA is found to be a sensitive and early marker for the diagnosis of prostate cancer. With a cut off value of 4ng/ml sensitivity was found to be 93.75% and specificity was 46.15%. Keywords: Adenocarcinoma prostate, Benign prostatic hyperplasia, Prostatic intraepithelial neoplasia, Prostatitis Serum prostate specific antigens.

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