Gastrointestinal, Liver and Biliary Tract Pathology: A Histopathological and Epidemiological Perspective from Pakistan with a Review of the Literature

Abstract

Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract (including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi, Pakistan. Materials and Methods: All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included. Results: A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (over 89%) on cholecystectomy specimens. Conclusions: Squamous cell carcinoma comprised 88.8% of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.

Gastrointestinal Stromal Tumors: A Clinicopathologic and Risk Stratification Study of 255 Cases from Pakistan and Review of Literature

“…In 2013, we published an epidemiological and histological perspective of diseases of the gastrointestinal tract in Pakistan (Ahmad et al, 2013). In the current article, an epidemiological, histological and risk stratification perspective of GIST is presented.…”

Clinical Study of Hepatectomy Combined with Jianpi Huayu Therapy for Hepatocellular Carcinoma

“…At present, effective treatment for HCC is still liver resection (including liver resection and liver transplantation, and local ablation) (Abdelgawad et al, 2013;Ahmad et al, 2013;Banjerdpongchai et al, 2013;Berk et al, 2013;Chittmittrapap et al, 2013;Gupta et al, 2013;Hao et al, 2013;Norsa'adah B et al, 2013;Zhu et al, 2013;Zhang et al, 2013;Zekri Ael-R et al, 2013). For patients with early disease, liver resection or liver transplantation could achieve a 5-year survival rate of 60-80%.…”

“…From previous reports on HCC from China or other countries, it is suggested that radical resection e.g. surgery, radio frequency or liver transplantation is still the most effective option for HCC treatment (Ye at al., 2009;Abdelgawad et al, 2013;Ahmad et al, 2013;Banjerdpongchai et al, 2013;Berk et al, 2013;Chittmittrapap et al, 2013;Gupta et al, 2013;Hao et al, 2013;Norsa'adah et al, 2013;Zekri Ael-R et al, 2013;Zhang et al, 2013;Zhu et al, 2013). However the invasiveness HCC is strong, and HCC is easy to relapse.…”

Pemetrexed is Mildly Active with Good Tolerability in Treating Patients with Gastric Cancer

“…Gastric cancer is a common disease in Asian Pacific area, and most medical resources are specially focused on the diagnosis and treatment of this disease (Ahmad et al, 2013;Atrkar-Roushan et al, 2013;Ma et al, 2013;Song et al, 2013;Suh et al, 2013;Tuncel et al, 2013;Zare et al, 2013;Zhang et al, 2013;Zhu et al, 2013). Combined chemotherapy was reported to be superior to the best supportive care in the man¬agement of MGC (Pyrhonen et al, 1995;Jo et al, 2007;Chen et al, 2013;Usakova et al, 2013).…”