Correlation between Histopathology Patterns and Endoscopic Findings of Gastrointestinal Lesions in South West Ethiopia: A-3 Years Retrospect

Abstract

Background: The gastrointestinal tract is a hollow tube consisting of the esophagus, stomach, small intestine, colon, rectum, and anus. Gastrointestinal tract diseases show regional variations. They are broadly categorized as upper and lower gastrointestinal lesions based on site. Gastrointestinal complaints are very common in Ethiopia. Gastrointestinal diseases are known to cause significant morbidity and mortality unless they are diagnosed and treated early. The treatment options and follow up of treatments in general depend on the findings of gastrointestinal endoscopy and histopathologic evaluation. This study will allow a reasonable evaluation of the correlation between histopathologic and endoscopic findings of gastrointestinal tract lesions which will be crucial in bridging the knowledge and research gaps in this area. Objectives: To assess the correlation between histopathologic and endoscopic findings of gastrointestinal tract lesions in South-West Ethiopia Methods: A three-year retrospective facility based study was conducted from September 15 to October 30, 2022. Data was collected from 318 eligible gastrointestinal endoscopic mucosal biopsy specimens submitted to pathology department from 11th of September 2020 to 10th of September 2022. After collection of histopathology and endoscopy reports of 318 cases they were retrospectively reviewed. Data was collected through observation of records, and then copied to data collection format prepared for this purpose. Data was cleaned, coded, checked for outliers and missed values and entered into Epidata v4.6 and exported to SPSS version 23 for analysis. Descriptive studies were done. Sensitivities, specificities and diagnostic accuracy of endoscopy were determined by taking histopathologic diagnosis as a gold standard diagnostic test. Result: 318 endoscopic mucosal biopsies were included in the study. M: F ratio was 1.3:1 with mean age of 49.6. Progressive dysphagia was the most frequent clinical indication for endoscopic evaluation which constitutes 121(38%) biopsies. 184(57.9%) biopsies were found to be malignant neoplasms and 106 (33.3%) were benign. Esophageal cancer 122(38.4%) was the most common endoscopic diagnosis. Esophageal squamous cell carcinoma was found in 100(31.4%) cases. Gastric adenocarcinoma and colorectal adenocarcinoma accounted for 24(7.5%) and 39 (12.3%) cases respectively. Endoscopy finding of esophageal carcinoma had a sensitivity of 99.1% and specificity of 80%. Endoscopy finding of gastric carcinoma had a sensitivity of 83.3% and specificity of 79.2%. Endoscopic findings of colorectal cancer showed a sensitivity of 100% and specificity of 97.9%. Conclusion: Progressive dysphagia is the most frequent clinical indication for upper GI endoscopic evaluation. Malignant neoplasms are the predominant histopathologic entities and esophageal squamous cell carcinoma is the most common malignancy. Endoscopic finding of malignancy in esophagus, stomach and colon has overall diagnostic accuracy of 98.3%, 80.5% and 99.8% respectively. Endoscopy in conjunction with histopathologic evaluation of biopsies is a useful adjunct for diagnosis of gastrointestinal lesions