Mide kanseri ve mide lenfomasinda Helikobakter pilori sikligi
Helicobacter pylori prevalance in gastric carcinoma and gastric lymphoma
Özet
Giris ve amaç: Mide malignitelerinde Helikobakter pilori sikliginin tani mlanmasi ve etiyolojideki degerinin saptanmasi amaçlanmistir. Helikobakter pilori enfeksiyonu gastrik adenokarsinom ve gastrik lenfoma riskinde artisla iliskilidir. Gereç ve yöntem: 1998-2005 tarihleri arasinda Ankara Egitim ve Arastirma Hastanesi 2. ve 5. Genel Cerrahi Klinikleri’nde malignite nedeniyle total ve subtotal mide rezeksiyonu yapilan 42 hastanin gastrik spesimenleri retrospektif olarak tekrar incelendi. Histolojik degerlendirme Lauren’s klasifikasyonu ve Helikobakter pilori yogunluk tayini için Sydney klasifikasyonu kullanildi. Bulgular: Çalismaya 32 gastrik karsinoma, 10 non-Hodgkin gastrik lenfoma vakasi alindi. Helikobakter enfeksiyonu; gastrik karsinomlu hastalarin 10’unda (%33.3), gastrik lenfomali hastalarin 7’sinde (%70) saptandi. Helikobakter yogunlugu 9 gastrik karsinomlu, 7 gastrik lenfomali hastada ‘1’ iken, 1 gastrik karsinom vakasinda ve 1 gastrik lenfomali hastada yogunluk ‘2’ idi. Mide lenfomasi vakalarinda Helikobakter pilori prevalansi anlamli olarak daha yüksek idi. Helikobakter pilori, intestinal tip gastrik karsinoma nazaran difüz gastrik karsinomada daha sik görüldü. Ayrica gastrik karsinom klinik evresi arttikça Helikobakter pilori yogunlugu da artmakta birlikte istatistiksel olarak bu bulgular anlamli bulunmadi. Sonuç: Gastrik maligniteler arasinda lenfoma olgularinda yüksek siklikta Helikobakter pilori bulunmasi gastrik lenfomanin olusmasinda Helikobakter pilori’nin rolünü dogrulamaktadir.
Abstract
Background/aim: We aimed to determine Helicobacter pylori prevalence in gastric malignant disease and to examine its value in the etiology. Infection with Helicobacter pylori is associated with an increased risk of gastric adenocarcinoma and gastric lymphoma. Materials and methods: We retrospectively examined the surgical specimens of 42 patients with malignant gastric tumors, who had been hospitalized in the second and fifth Department of General Surgery, Ministry of Health Ankara Training and Research Hospital, between 1998 and 2005 and treated with gastrectomy. Histological assessment and Helicobacter pylori density determinations were made according to Lauren and Sydney classifications, respectively. Results: Thirty-two had gastric carcinoma and 10 had gastric non-Hodgkin lymphoma. Helicobacter pylori infection was present in 10 (33.3%) of the gastric carcinoma patients and 7 (70%) of the gastric lymphoma patients. The density of Helicobacter pylori was ‘1’ in nine gastric carcinoma and six gastric lymphoma cases, and ‘2’ in one gastric carcinoma and one gastric lymphoma case. Helicobacter pylori prevalence is significantly higher in lymphoma cases than carcinoma cases. Diffuse type gastric carcinoma is more correlated with Helicobacter pylori than the intestinal type, and Helicobacter pylori density increases in conjunction with an increase in the gastric carcinoma clinical stage, but these findings were not significant. Conclusion: A high prevalence of Helicobacter pylori among the gastric lymphoma patients confirms the role of Helicobacter pylori in gastric lymphoma genesis.
