HISTOPATHOLOGICAL STUDY OF GASTRIC MUCOSAL BIOPSIES IN CHRONIC GASTRITIS PATIENTS WITH SPECIAL CORRELATION TO HELICOBACTER PYLORI INFECTION AT RIMS HOSPITAL

Abstract

Sampa Choudhury1, Rajesh Singh Laishram2, P. Punyabati3, G. S. Moirangthem4, Kaushik Debnath5

BACKGROUND
Chronic gastritis is a common condition in general population. Of the many aetiological factors, Helicobacter pylori is one of the primary cause of chronic gastritis.
AIMS
? To study the histopathological features of chronic gastritis associated with H. pylori infection.
? To find out the relationship between severity of inflammatory reaction in gastritis and intensity of H. pylori.
MATERIALS
This cross sectional study was carried out in Regional Institute of Medical Sciences (RIMS) Hospital from October 2013 to September 2015. Patients with symptoms suggestive of chronic gastritis attending RIMS OPD were subjected to upper gastrointestinal endoscopy. One of the biopsy specimens was used for rapid urease test using RUT dry test kit and others were processed for histopathological examination as per standard protocol. All the slides were stained with Haematoxylin and Eosin (H&E) stain and Giemsa stain. Histological variable grading was done using the “Updated Sydney System 1994”. All the data thus collected were analysed.
RESULTS
A total of 60 patients (39 males and 21 females) were included in the study with age ranging from 19 to 82 years. Among the 60 patients, maximum endoscopic findings were ulcer (33.3%) followed by erythematous findings (26.7%). The results of Rapid Urease Test (RUT) were positive in 30% (18/60). The histopathology reports for H. pylori detection were positive in 35% (21/60). The majority (81.7%) of the cases were inflammatory on histopathology followed by neoplasia (8.3%), dysplasia (5%) and normal finding (5%). Neutrophilic activity was present in all cases of chronic gastritis, in which 15, 5 and 11 numbers of cases showed mild, moderate and severe grading respectively. Mononuclear cell infiltration also was present in all cases of chronic gastritis and 8, 16, 7 numbers of cases were found to have mild, moderate and severe grading respectively. Only five mild atrophy, four mild Intestinal metaplasia (IM) and one moderate Intestinal metaplasia (IM) were found in gastritis cases. Correlation coefficient of neutrophilic activity with H. pylori density was 0.725 (p=0.000), which was statistically significant.
CONCLUSION
In our study, histopathological features of H. pylori associated chronic gastritis have shown H. pylori density, neutrophilic activity, mononuclear cell infiltration, glandular atrophy and intestinal metaplasia. We also have observed the association between neutrophilic activity and H. pylori density.

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