Analysis of gastric and duodenal biopsy results in patients presenting with dyspepsia: a cross-sectional study in a middle eastern population

Abstract

ObjectiveCorrea’s cascade is a ‘Model for Gastric Cancer Development’ described by Peleyo Correa. The reversibility of Correa’s cascade remains debatable. The literature contains insufficient data on the specific stage of the cascade during which Helicobacter pylori is detected, treated, and the effect on prognosis. Herein, we aim to determine the prevalence of various precancerous and cancerous gastric lesions in patients presenting with dyspepsia, the prevalence of gastritis and H. pylori infection, the prevalence of duodenal pathology in patients presenting with dyspepsia, identify the stage of H. pylori detection in relation to Correa’s cascade, and investigate a possible relationship between H. pylori and celiac disease.DesignRetrospective cross-sectional study conducted on a middle eastern population at a Lebanese tertiary hospital centre. 1428 patients presenting with dyspepsia underwent gastroscopy with gastric and duodenal biopsies. Variables include age, sex, presence/absence of H. pylori infection, and histopathological analysis of gastric and duodenal biopsies.ResultsBeing above 40 years of age was associated with increased likelihood of exhibiting abnormal gastric biopsy result. Gastritis and metaplasia were detected more frequently than glandular atrophy (p<0.001) with gastritis being present the most (p<0.001). The presence of H. pylori and the gastric biopsy results were not associated with any of the duodenal biopsy results.ConclusionThe burden of H. pylori infection in patients with dyspepsia was high. H. pylori was detected at various precancerous lesions with varying significance. The prevalence of duodenal adenocarcinoma in dyspeptic patients is unexpectedly high. No association between gastric and duodenal pathologies was found.

Diagnostic utility of endoscopic duodenal biopsies and histopathological finding in upper gastrointestinal diseases: A 2-year analysis

“…Ghosn et al, conducted a study of 1428 patients presenting with dyspepsia who underwent gastroscopy with gastric and duodenal biopsies. 14 The authors found that age above 40 years was associated with increased likelihood of exhibiting abnormal gastric biopsy result. Gastritis and metaplasia were detected more frequently than glandular atrophy (P<0.001) with gastritis being present the most (P<0.001).…”

Preneoplastic Gastric Lesions and Helicobacter Pylori in Endoscopic Detection and Early Diagnosis of Gastric Cancer in Lebanese Population. A Retrospective Study from 2019-2020

“…In Lebanon, many factors have been found to be associated with increased risk of stomach cancer including a high sodium diet, obesity, smoking, and moderate alcohol consumption [9]. However, to the best of our knowledge, epidemiological data of PGL in the Lebanese population has never been reported.…”

Spectrum of Histopathological Lesions in patients undergoing Gastroduodenal Biopsies in a Tertiary Care Centre in North Karnataka, India

“…Histopathological study helps in confirmation of a benign/inflammatory or malignant condition, allowing for an early management without unnecessary delay. Endoscopy is known to be less discomforting, and well tolerated, with a direct visual of lesion [2,4,7].…”

“…Clinical symptoms vary from dysphagia to dyspepsia to altered bowel movements, which pathologically could vary between the common non-neoplastic and neoplastic lesions. Dyspeptic symptoms, secondary to H.pylori infection can lead to debilitating consequences, particularly increasing the risk of adenocarcinoma [3][4][5][6].…”