Detection of Intestinal Metaplasia among Sudanese Patients with Chronic Gastritis by Using Combined Alcian BluePAS Technique

Abstract

Background and aim: Gastric cancer (GC) is one of cancer that leads to death in the world. GC is usually developed through a series of mucosal changes from non-atrophic gastritis to atrophic gastritis (AG), intestinal metaplasia (IM), dysplasia and adenocarcinoma. Helicobacter pylori (H.pylori) infection is an important initiating and promoting step of this gastric carcinogenesis. The current study conducted to identify the frequency of H.pylori and (IM) among Sudanese patients with Gastritis and to determine the role of combined PAS/ Alcian blue stain to detect intestinal metaplasia Materials and methods: This retrospective study was conducted on 100 formalin fixed paraffin embedded blocks of gastric biopsies with chronic gastritis, severity of gastritis was graded. Results: Hundred formalin fixed paraffin embedded Blocks from patients with gastritis were enrolled, of which 64 (64%) were females and 36 (36%) are males. Age range from 14 to 80 years with median age of 47 .The activity of gastritis was mild in 48%, moderate in 43% and severe in 8% of cases. Intestinal metaplasia was present in 10% (10/100). Concerning H.pylori infection as evaluated by H&E was reported in 49% of cases , among which 69% (34/49) of patients with chronic active gastritis were positive against 31% (15/39) of non-active chronic gastritis (p=0.000). H.pylori infection was related to the severity of gastric (p=0.01). H.pylori considered to be positive in antrum more than Fundus according to the site of biopsy a (p=0.003). Seven negative intestinal metaplasia observed by H&E, appear to positive when reviewed by the alcian blue combined with PAS, so the IM reported to be positive in 3% and 10% by H&E and alcian combined with PAS respectively. Conclusion: this study concludes that H.pylori are most frequent cause of chronic gastritis. A significant cases of IM were detected using combination of alcian blue-PAS stain among patients with chronic gastritis.