A study on histomorphological analysis of upper gastrointestinal tract endoscopic biopsies

Abstract Background: The upper gastrointestinal tract (UGIT) is frequently affected by various pathological conditions, including infections, inflammatory disorders, and a range of pre-neoplastic to neoplastic changes. Among the malignancies that commonly affect the UGIT, gastric adenocarcinoma and esophageal carcinoma are the 5th and 7th leading causes of cancer-related deaths worldwide, respectively. Early detection of malignancy and its predisposing factors, such as Barrett’s esophagus and Helicobacter pylori infection, can significantly improve survival rates through histopathological examination (HPE) of endoscopic biopsies. This is achieved by enabling prompt treatment, monitoring disease progression, assessing therapeutic responses, and detecting complications at an early stage. Histopathological examination of endoscopic biopsies from UGIT lesions is essential and plays a crucial role in the early detection and definitive diagnosis of malignancies and their precursor lesions. Understanding the histopathological spectrum of UGIT lesions and their demographic profiles is important in this context. Aims and Objectives: The study aimed to examine the histomorphological characteristics and range of UGIT lesions, along with their demographic profiles and anatomical locations. Materials and Methods: A descriptive cross-sectional study was conducted in the Department of Pathology over a period of two and a half years, from January 2022 to June 2024. Results: A total of 95 UGIT biopsies were analyzed. Of these, 71 cases (74.7%) were malignant. Adenocarcinoma was the most commonly diagnosed malignancy, accounting for 52 cases (73.2%), followed by squamous cell carcinoma in 17 cases (23.9%). Non-malignant lesions constituted 25.3% of cases, with chronic nonspecific gastritis being the most prevalent (54%). Other significant non-malignant conditions included Barrett’s esophagus, Helicobacter pylori gastritis, and intestinal metaplasia—each recognized as predisposing factors for malignancy. Conclusion: This study revealed a higher prevalence of malignant (74.7%) than benign (25.3%) UGIT lesions. Early and accurate diagnosis of malignant and pre-malignant conditions through HPE of UGIT biopsies is essential for prompt treatment and reducing cancer-related mortality. The findings underscore the importance of histomorphological evaluation in understanding the pathology and distribution of UGIT lesions, which can guide effective clinical management.