Histopathologic Study of Gastritis and Helicobacter Pylori Infection at a Tertiary Centre in Kathmandu

Abstract

Introduction: Chronic gastritis is a chronic inflammation of the gastric mucosa characterized by infiltration of the superficial mucosa by chronic inflammatory cells and with progressive spread to involve the whole mucosa leading to atrophy and intestinal metaplasia and may even progress to the development of carcinoma. Chronic infection with Helicobacter pylori (H. Pylori) is believed to be the major causative agent in the pathogenesis of chronic active gastritis, duodenal and gastric ulcer along with gastric carcinoma. Sydney system classifies gastritis by the intensity of mononuclear inflammatory infiltrates, activity of polymorphs, atrophy, metaplasia and dysplasia and presence of H. pylori.

Methods: Observational, descriptive, cross-sectional retrospective study conducted at Department of Pathology, Kathmandu Model Hospital, Kathmandu, Nepal from January 2015 to December 2015. Record of computerized histopathology reports of all cases of endoscopic gastric biopsies were retrieved from the laboratory. The biopsy samples obtained from both body and antrum were included in the study. The grades of mononuclear cells infiltration, neutrophilic activity, metaplasia, dysplasia and glandular atrophy were determined using the Sydney system classification. The presence or absence of H. pylori was noted in the slides stained with Giemsa stain. Data analysis was done using a Microsoft Excel file.

Results: Of 128 samples studied, the most common endoscopic findings were erythematous lesions and mononuclear infiltrate was seen in all cases. 61.7% showed moderate inflammation. The activity was seen in 35.9% of cases. H. pylori organism was noted in 48.4% of cases.

Conclusion: The severity of chronic inflammation and neutrophilic activity are significantly associated with infection by this microorganism.