INTERRELATIONSHIPS OF THE SYDNEY GRADED VARIABLES: A STUDY OF GASTRIC ENDOSCOPIC BIOPSIES IN EDO-DELTA, NIGERIA.
M.O. Udoh, D.E Imasogie
Department of Histopathology,
University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
Email: moludoh@yahoo.co.uk
ABSTRACT
Introduction: Chronic Gastritis is reported based on semi-quantitative grading of ‘the Sydney’ morphologic variables. A proportion of patients with chronic Gastritis may progress to atrophic gastritis of varying morphology and grades during their lifetime, with attendant sequelae. A precise prediction of specific pattern of progression and sequelae cannot always be made for a given patient, most likely due to differences in individual and population genetics. More predictable patterns may emerge as subsets of larger populations are studied to detect patterns that may deviate from the expected.
Aim: To evaluate the relationships between the histologic parameters of the Sydney system, in a small Nigerian population.
Materials and Methods: The clinical data and slides processed from paraffin embedded tissue blocks of endoscopic biopsies of 117 patients from the Edo-Delta axis of Nigeria with histologic diagnosis of chronic in the gastritis were studied, statistically analyzed and presented.
Results: There were 117 patients, 60 males and 57 females. Age range:15-86 years; mean age = 48.6 years+1.56; modal age group, 50-59 years. There is a strong association between the presence of Helicobacter pylori and presence of activity (p value < 0.001) and grade of Helicobacter pylori and grade of activity (p value = 0.029) . Helicobacter pylori presence and atrophy are also related, but the relationship between their grades are not statistically significant (p value = 0.136). Helicobacter pylori presence is not significantly associated with intestinal metaplasia (p value = 0.917); but intestinal metaplasia is strongly related to atrophy (p value < 0.001). Unlike in some studies, we could not establish a statistically significant relationship between the density of Helicobacter Pylori infection and the grade of mononuclear inflammation (p value = 0.494).
Conclusion: Earlier events in the progression chronic atrophic gastritis are strongly linked to Helicobacter pylori infection. While later events are less strongly linked. The weaker/ non-statistically significant association of Helicobacter pylori with Atrophy and Intestinal Metaplasia suggest that other factors have a role to play in the progression of chronic gastritis to the atrophic /metaplastic Keywords: Chronic Gastritis, Graded Variables, Helicobacter Pylori,