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

2. The Morphology Point of the History of the Problem 3 points: 1. Displasia 2. Intestinal Metaplasia 3. Bacteriology – Helicobacter pylori

3. 1.DISPLASIA - 1

4. 1.DISPLASIA - 2

5. 2. INTESTINAL METAPLASIA - 1

6. 2. INTESTINAL METAPLASIA - 2

7. 2. INTESTINAL METAPLASIA - 3

8. 2. INTESTINAL METAPLASIA - 4

9. 2. INTESTINAL METAPLASIA - 5

10. 2. INTESTINAL METAPLASIA - 6

11. 3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

12. 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

13. 3. THE NEW ERA – BACTERIOLOGY – HELICOBACTER PYLORI

16. 5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 1 Polychromatic Methods 1 – R. Genta (1994) X 64 X 400

17. 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

18. 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

19. 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 400

20. 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

21. 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)

22. 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.

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

24. The First Bulgarian SEM of Helicobacter pylori – 1993 - 1 i.e. long form of H.P.

25. 5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 3 The First Bulgarian SEM of Helicobacter pylori – 1993 - 2 2 long form of H.P.

26. 5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 4 The First Bulgarian SEM of Helicobacter pylori – 1993 - 3 “battle field” in the ulcer border

27. 5. THE NEW ERA – OUR CONTRIBUTION – HELICOBACTER PYLORI - 5 The First Bulgarian SEM of Helicobacter pylori – 1993 - 4 i.e. “cigar shaped” form Of H.P.

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

29. GASTRITES & HELICOBACTER PYLORI - 2 6. THE NEW ERA – OUR RESULTS – HELICOBACTER PYLORI - 2

30. 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%

31. 6. THE NEW ERA – OUR RESULTS – HELICOBACTER PYLORI - 4 HELICOBACTER PYLORI in GASTRIC CARCINOMAS (according to Pekka Lauren) - 2

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