Evaluation of chronic gastritis in endoscopic antral biopsies using the Up-dated Sydney system

Abstract EN

Objectives: To evaluate the histological parameters of chronic gastritis in endoscopic antral biopsies, to grade them according to the up-dated Sydney system and to compare the obtained results with those of others.

Methods:From the 1st of July 2018 to the end of December 2018,100 endoscopic antral gastric biopsies were submitted to the Histopathology Unit in Al-Salam Teaching Hospital in Mosul, obtained from patients complaining of different clinical symptoms and referred for upper gastrointestinal endoscopy.

Biopsies were assessed for the histological parameters of chronic gastritis and were also graded using the visual analogue scale of the up- dated Sydney system.

Results:The 100 biopsies belonged to 42 males and 58 females ranging from 9-85 years old with a mean of 42.7 years and a peak age incidence in the fourth decade.

The commonest symptom was epigastric pain in (46%) of cases.

Antral gastritis was the major endoscopic finding in (66%) of cases.

All cases revealed mononuclear cell infiltration(100%), followed by neutrophilic activity (84%), glandular atrophy(22%), intestinal metaplasia(14%) and dysplasia(9%).Helicobacter pylori (H.

pylori) was detected in(77%) of cases and a significant statistical association was found between H.

pylori and each of: mononuclear cell infiltration(P<0.001), neutrophilic activity (P<0.001) and glandular atrophy (P<0.05).

while insignificant statistical association was observed between H.

pylori and both intestinal metaplasia and dysplasia (P>0.05).

Conclusion:Histopathological study of endoscopic antral gastric biopsy is of value in detection of H.

pylori and various histological changes of chronic gastritis.

A statistically significant association was found between H.

pylori and each of : mononuclear cell infiltration, neutrophilic activity and glandular atrophy.

Dysplasia is an important histological change in chronic gastritis that requires endoscopic follow up to rule out the possibility of gastric cancer, and it is advisable to be incorporated in the visual analogue scale of the up-dated Sydney system.