Malignant Tumors of the Upper Aerodigestive Tract as Seen in a Nigerian Tertiary Health Institution

Background: Cancers of the upper aerodigestive tract constitute a diverse heterogeneous group of malignant neoplasms with unique epidemiological; pathological; and treatment considerations. Only few studies have been conducted so far on these tumors in Nigeria. This study aims to study in greater detail; the pathological features of these cancers in Nigerian patients. Materials and Methods: The surgical specimens of patients diagnosed with malignant tumors of the upper aerodigestive tracts in the Department of Morbid Anatomy and Forensic Medicine; Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) in Ile-Ife; Nigeria; over a 10-year period; formed the basis of this study. Analysis was done for differences in proportion using the Chi-square test (P is significant at 0.05) by SPSS version 15. Results: There were a total of 62 cases. The overall mean age was 50.7 years; while the age range was from 3 years to 90 years. The male to female ratio was 3.1:1. A majority of the patients (67.7) were older than 40 years. About 30.6; 27.4; and 16.1 of cases occurred in the larynx; nasopharynx; and nasal cavity; respectively; while 93.5 of the tumors were carcinomas. Squamous cell carcinoma was the most common histological variety. Nonepithelial tumors were not seen below the age of 20 years. Conclusion: This study shows that malignant upper aerodigestive tract tumors seen in our environment are mainly diseases of adulthood that tend to occur about seven to nine years earlier than in other populations. Squamous cell carcinoma is the predominant histological variety. Although the larynx is the most frequent anatomic site; the nasopharynx and nasal cavity are more commonly affected than the oral cavity unlike in other populations. Nonepithelial tumors are extremely rare below the age of 20 years

Correlation between endoscopic suspicion of gastric cancer and histology in Nigerian patients with dyspepsia.

Gastric mucosal biopsies of 77 dyspeptic patients whose endoscopic features were suggestive of cancer and 56 patients with uncomplicated duodenal ulcer (DU) were subjected to histopathological analysis. Gastric cancer was confirmed in 18 (23.4%) of the 77 patients but not in 59 (76.6%). 4 (5.2%) of the 18 patients had early gastric cancer (EGC). Histopathological findings in the stomach biopsy of the 59 patients in whom cancer could not be confirmed were compared with those of the 56 patients with DU. Intestinal metaplasia (IM) was present in 32.2% of the 59 cases with endoscopic suspicion of gastric cancer and in 16.1% of the 56 DU controls (P < 0.05). Mucosa-associated lymphoid tissue (MALT) occurred in 28.8% of the cancer-resembling cases and in 12.5% of the DU patients (P < 0.05). The difference in the prevalence of gastric mucosal atrophy and Helicobacter pylori infection between the two groups (83% vs. 71.4%) did not reach statistical significance (P > 0.10). All 18 patients with gastric cancer were positive for Helicobacter pylori and the prevalence of the infection approached 95% in those with IM and MALT. This study shows that IM and MALT present with endoscopic appearances that resemble that of gastric cancer and that along with the latter, their main aetiological agent is Helicobacter pylori.