Histopathological Profile of the Gastrointestinal Polyps in Kashmir Valley

Abstract

Introduction: A gastrointestinal (GI) polyp is a discrete mass protruding into the lumen of GI Tract projecting above the plane of the mucosal surface .Polyp may be neoplastic and neo-neoplastic in nature. Determining the potential risk of malignancy of the polyp is very important for the purpose of line of treatment. The polyp size and histological types are important factors for development of cancers in polyps.Materials and Methods: This was a five year observational study conducted from 2012-2016. All the patients diagnosed with true Gastro-intestinal polyps enrolled in Sher-i-Kashmir Institute of Medical Sciences, Kashmir were analyzed. Data regarding the clinico-pathological parameters was collected. Gastrointestinal polyps were grouped as per age, location, number, presence and absence of stalk, presence and absence of dysplasia; and histological type. The data was analyzed using the statistical software SPSS version V 20.Results: Among 595 patients reported, 373 (62.7%) were males and 222 (37.3%) were females. The age of the patients ranged from 1 to 90 years. Mean age was 40 years .Majority of the polyps ( 74%) were found in large intestine. 63.19% were non-neoplastic and 36.8% were neoplastic. 90.76% percent of the patients presented with single polyps . Sessile polyps were seen in 90.76%. Majority of cases had adenomatous polyps (36.8%), followed by hyperplastic polyps (30.92%). The sub types of the adenomatous polyps were tubulovillious with 56.22 % followed by tubular and villious type with 28.31% and 15.06 %respectively. Among adenomatous polyps, 62.10 % were with dysplasia while 37.90% were without dysplasia. Four cases of Familial Adenomatous polyposis (FAP) were observed. 15 patients presented with 9 synchronous and 6 metachronous lesions . Conclusion:The high prevalence of adenomatous polyps in our study warrants need of screening for early detection and prevention of colorectal carcinomas. Genetic and molecular screening evaluation may also have a huge impact on understanding the mechanism of neoplastic polyps.

Profile of Colonic Polyps in a Tertiary Care Centre in South India

“…In regards to associated dysplasia in polyps , Tony J et al 3 showed that severe dysplasia was found in 43% of polyps with villous pattern and 12% of those with tubular pattern however in this study only 1.8 % of polyps with pure tubular pattern had high grade dysplasia while 30.4 % with tubulovillous variety (p<0.001) had high grade dysplasia suggesting that villous component increases the neoplastic potential of the polyps.Other Indian studies by Ashraf et al 12 from Kashmir and Amarapurkar series 10 from Mumbai also had similar finding of increasing severity of dysplasia with presence of villous component.…”