CORRELATION BETWEEN ENDOSCOPY, HISTOPATHOLOGY, AND DNA FLOW-CYTOMETRYIN PATIENTS WITH GASTRIC DYSPEPSIA

Background/Aims: Gastric cancer has a poor prognosis, this is partly d ue to the advanced stage in which the tumor is diagnosed. The objectiv e of this study is to elucidate the clinical significance of DNA flow cytometry and study its impact on monitoring the progression of gastri c precancerous lesions in patients with gastric dyspepsia, and to corr elate between endoscopic and histopathological findings with results o f DNA flow cytometry. Material and Methods: A total of 92 cases underw ent upper gastrointestinal endoscopy, 69 males with mean age 44.0 year s and 23 females with mean age 38.7 years. Based on the endoscopic app earance, patients under study were classified into: 15 cases with endo scopic normal mucosa (EN), 26 cases with endoscopic gastritis (EG), 43 cases with duodenal ulcer (DU), and 8 cases with gastric ulcer (GU). Two antral biopsies were taken for histopathology and DNA flow cytomet ry. Results: Chronic gastritis (CG) was present in 12 (80%) of EN case s. In DU patients, CG was present in 42 (97.7%) of cases, and it was a ssociated with in testinal metaplasia (IM) in 11 (25.6%), and with dys plasia in 9 (20.9%) of these cases. While in GU patients, CG was prese nt in all cases. Two (13.3%) of endoscopic normal cases revealed DNA a neuploidy in specimens with CG. The incidence of aneuploidy increases as the endoscopic findings changes from EG (15.4%), DU (16.3%) to GU ( 37.5%), and as the histopathological changes progresses from chronic a trophic gastritis (CAG) (18.2%), IM (21.7%) to dysplasia (33.3%). Conc lusion: DNA aneuploidy is a useful marker for recognizing the presence of abnormal cells in epithelial lesions of the stomach, and for monit oring the progression of gastric lesions. Patients with gastric dyspep sia should not only be subjected to endoscopy but also to biopsy and D NA flow cytometry to allow the early detection of malignant transforma tions in gastric precancerous lesions.