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Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

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Page 1: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

Stefan P. Petrov, MD; PhDSt. Ann Hospital, Sofia

PRECANCEROUS GASTRIC LESIONS

- our Bulgarian experience

10 – 12 – 2010SOFIA

Page 2: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

The Morphology Point of the History of the Problem 3

points:

1. Displasia2. Intestinal Metaplasia

3. Bacteriology – Helicobacter pylori

Page 3: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

1.DISPLASIA - 1

Page 4: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

1.DISPLASIA - 2

Page 5: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

2. INTESTINAL METAPLASIA - 1

Page 6: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

2. INTESTINAL METAPLASIA - 2

Page 7: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

2. INTESTINAL METAPLASIA - 3

Page 8: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

2. INTESTINAL METAPLASIA - 4

Page 9: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

2. INTESTINAL METAPLASIA - 5

Page 10: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

2. INTESTINAL METAPLASIA - 6

Page 11: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

Page 12: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

UNIDENTIFIED CURVED BACILLI ON GASTRIC EPITHELIUM IN ACTIVE CHRONIC GASTRITIS

UNIDENTIFIED CURVED BACILLI IN THE STOMACH OF PATIENTS WITH GASTRITIS AND PEPTIC ULCERATION

BJ Marshall & JR Warren, Dept of Gastroenterology and Pathology,Royal Perth Hospital, Perth, Western Australia

The Lancet, june 4, 1983

Page 13: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

Page 14: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

Page 15: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

Page 16: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 1

Polychromatic Methods 1 – R. Genta (1994)

X 64

X 400

Page 17: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 2

Polychromatic Methods 2 – C. Doglioni (1997)

simultaneously identification of the H.P. & Helicobacter Heilmanii

X 1000

Page 18: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 3

Polychromatic Methods 3 – Hala El-Zimaity (1998) simultaneously identification of the H.P. & Intestinal Metaplasia

X 128

X 400

X 1000

Page 19: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 4

Impregnation Methods 1 – AgNOR и H.P. – impregnation

( W.Howell & D. Black /1980/– modification by D. Plotton /1984/) simultaneously identification of the H.P. & Proliferative Activity

X 400X 400

X 400

Page 20: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – TREPONEMA PALLIDA - 1

Impregnation Methods 2 – the golden standard – Whartin - Starry (1984) Siphylitic gastropathia – 29 year man

X 128

X 400

Page 21: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 1

Combined Methods 1 – Granofurine – Evans-Blue – Jodasept

simultaneously identification of the H.P. & fluorescence (an attempt)

Page 22: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 1

PATENTED № 202 / 30.07.1998 г. INRA

Advantages of application of a yellow filter and

simple half-Gram staining for detection of

Helicobacter pylori, Modern Pathology, 8; 3,

1995, 339 – 340 pp.

Page 23: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 2

Page 24: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 2

The First Bulgarian SEM of Helicobacter pylori – 1993 - 1

i.e. long form of H.P.

Page 25: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 3

The First Bulgarian SEM of Helicobacter pylori – 1993 - 2

2 long form of H.P.

Page 26: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 4

The First Bulgarian SEM of Helicobacter pylori – 1993 - 3

“battle field”in the ulcer

border

Page 27: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 5

The First Bulgarian SEM of Helicobacter pylori – 1993 - 4

i.e. “cigar shaped”

formOf H.P.

Page 28: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

6. THE NEW ERA – OUR RESULTS – HELICOBACTER PYLORI - 1

GASTRITES & HELICOBACTER PYLORI - 1

Page 29: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

GASTRITES &

HELICOBACTER PYLORI - 2

6. THE NEW ERA – OUR RESULTS –

HELICOBACTER PYLORI - 2

Page 30: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

6. THE NEW ERA – OUR RESULTS – HELICOBACTER PYLORI - 3

ALL GASTRIC MALIGNANT TUMORS & HELICOBACTER PYLORI - 1

Fig 3. Helicobacter Heilmanii (4) – 0.496 % from all biopsies

and 0.98 from Helicobacter ( + ) – association between both in 25%

Page 31: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

6. THE NEW ERA – OUR RESULTS – HELICOBACTER PYLORI - 4

HELICOBACTER PYLORI in GASTRIC CARCINOMAS (according to Pekka Lauren) - 2

Page 32: Stefan P. Petrov, MD; PhD St. Ann Hospital, Sofia PRECANCEROUS GASTRIC LESIONS - our Bulgarian experience 10 – 12 – 2010 SOFIA

7. THE NEW ERA – BULGARIAN PATHOLOGY ASSOCIATION(since 2009)