Histomorphological Interpretation of Gastric Endoscopic Mucosal Biopsies in Dyspeptic Patients with Special Reference to Immunohistochemical Demonstration of Helicobacter Pylori

Background & Objectives: The aim of this study was to evaluate the role of endoscopic biopsies for detection of Helicobacter Pylori to see the frequency of this infection and histological changes that are strongly associated with it, in our setup. Fifty three cases of endoscopic biopsies were included in the study. These patients had a clinical history of dyspeptic symptoms, especially those with chronic gastritis. Results: Of the total 53 cases studied there was a clear male preponderance with M: F ratio of 2: 1 with a mean age of 46.5 years. Of the 53 cases of studied most of them had chronic H. pyloric gastritis [n=20 (44.4 %)] followed by chronic gastritis with non specific features [n=18].25 of the 53 cases showed positivity for H pylori which was confirmed with IHC of which 20 (32.7 %) were chronic H. pyloric gastritis. Carcinoma was seen in 10 cases with diffuse type of adenocarcinoma in 7 (70.0 %) 2 (20.0 %) cases of intestinal adenocarcinoma and 1 (10.0 %) case of mucinous carcinoma of which 4 cases showed carcinoma positive for H. pylori. The modified Giemsa is the cheapest and easiest to perform technically but antibodies directed against specific antigens in IHC proved to be more specific in identifying H. Pylori than other staining techniques. Interpretation and conclusion: In conclusion Gastric biopsy brings important practical supplement to endoscopic examination in revealing the presence of H. pylori and also some serious pre-malignant dysplasia or malignant gastric lesions. Our study also highlighted the association of Helicobacter Pylori in patients with functional dyspepsia and proving Immunohistochemistry being gold standard in picking up Helicobacter Pylori with Geimsa being practically applicable in Indian set up keeping the cost factor in mind.