JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Background: Mucin secretions reflect the composition changes in the functional state of the mucosa in health and disease of the upper gastrointestinal tract. Objectives: To study the different types of upper gastrointestinal tract lesions and to determine the role of mucin histochemistry in the interpretation of lesions of upper gastrointestinal tract. Methods: A prospective study from September 2006 to August 2007 was carried out. 60 endoscopic biopsy specimens obtained from upper gastrointestinal tract lesions from the department of Gastroenterology at R.L. Jalappa Hospital & Research Centre was sent for histopathological examination. All the sections were stained by routine Haematoxylin and Eosin stain followed by special stains for mucins i.e Alcian blue pH 2.5 / PAS and Hale's Colloidal Iron. Results: Age of presentation of various upper gastrointestinal lesions was between 26-90 years. Females dominated the study group i.e. 39 (65%) when compared to males i.e. 21 (35%). Alcian Blue/Periodic Acid Schiff (AB/PAS) staining in oesophageal lesions could detect mixture of acidic mucins & neutral mucins and sulphomucins in Barrett's oesophagus. In gastritis, predominantly mixture of acidic and neutral mucins and in one case, sulphomucins were detected. Adenocarcinoma of stomach showed combination of acidic and neutral mucins. Duodenitis showed acidic, neutral and sialomucins. Adenocarcinoma of duodenum showed combination of acidic & neutral mucins. Hale's Colloidal Iron (HCI) stain in inflammatory & neoplastic lesions of stomach & duodenum, could detect only acidic mucins. Conclusion: In neoplastic condition of stomach this study suggests that those tumours which secrete neutral and mixed mucins probably arise from gastric epithelium and neck cells of the gastric glands. In those cases where the tumour produces acidic mucins it is possible the tumour arose from areas of intestinal metaplasia.

Key words: Mucins, Histochemistry, Alcian Blue / Periodic Acid Schiff, Hale's Colloidal Iron