Nisan 2020
Üst gastrointestinal sistem endoskopi uygulanan hastalarda intestinal metaplazi sikliginin arastirilmasi
Investigation of the incidence of metaplasia in patients undergoing upper gastrointestinal system endoscopy
- Ana Sayfa
- Sayılar
- Nisan 2020
- Üst gastrointestinal sistem endoskopi uygulanan hastalarda intestinal metaplazi sikliginin arastirilmasi...
Özet
Giris ve Amaç: Intestinal metaplazi; epitelyumun, kronik mukozal irritasyona bagli olarak bagirsakta bulunana benzer bir epitel türüne dö-nüsümüdür. Intestinal metaplazinin risk faktörleri; Helicobacter pylorienfeksiyonu, etnik köken, sigara ve alkol kullanimi, hormonlar, pH’dakidegisimler, yüksek tuz alimi ve kronik safra reflüsünü içermektedir. Buçalismanin amaci, farkli endikasyonlarla endoskopi uygulanan hastalarda intestinal metaplazi varligini ve risk faktörleri ile iliskisini arastirmak,ayrica literatür esliginde intestinal metaplazi yayginligini irdelemektir.Gereç ve Yöntem: Hastalarin yas ve cinsiyet gibi demografik özellikleri,sigara ve alkol kullanimi, aile öyküsü, pilorun açiklik durumu, endoskopik metaplazi bulgulari, patolojik bulgulari (histopatolojik özellikler,safra gastriti, Helicobacter pylori, atrofi, displazi ve intestinal metaplazivarligi) intestinal metaplazi türü, Helicobacter pylori varligi, kaydedilerekretrospektif olarak analiz edilmistir. Bulgular: Çalismaya yaslari 15-49yil arasinda degismekte olan toplam 217 hasta dahil edilmistir. Hastalarin 106’si (%48.8) erkek olup, ortalama yas 33.23±7.87 yil olaraksaptanmistir. Katilimcilarin 88’i (%43.3) sigara ve 46’si (%22.7) alkolkullanmaktadir. Hastalarin 51’inde (%23.5) endoskopide metaplazi gö-rüntüsü saptanirken, patolojik raporu metaplazi olarak gelen hastalarinsayisi ise 72’dir (%33.18). Saptanan metaplazilerin tamami komplet türmetaplazidir. Hastalarin 85’inde (%39.17) Helicobacter pylori pozitifsaptanirken, bu hastalarin 75’inde (%34.56) Helicobacter pylori varligipatolojik olarak dogrulanmistir. Metaplazi saptanan ve saptanmayanolgular arasinda Helicobacter pylori pozitifligi, sigara ve alkol kullanimi,yas, cinsiyet ve aile öyküsü açisindan anlamli fark saptanmamistir (hepsiiçin p >0.05). Sonuç: Intestinal metaplazi sikligi yeme aliskanliklari veyasam tarzi degisiklikleri ile büyük ölçüde azaltilabilir. Intestinal metaplazinin yeterince erken bir asamada saptanarak tedavi edilmesi, midekanseri sikliginin azaltilmasi açisindan büyük önem tasimaktadir.
Abstract
Background and aims: Intestinal metaplasia is the transformation ofthe epithelium such that it resembles the epithelium of intestines withchronic mucosal irritation. Risk factors of intestinal metaplasia includeHelicobacter pylori infection, ethnic origin, smoking and alcohol consumption, hormones, changes in pH, high salt intake, and chronic biliaryreflux. The objective of this study was to investigate the presence ofintestinal metaplasia and its relationships with the risk factors in thosepatients who underwent endoscopy with different indications and toexamine whether the incidence of intestinal metaplasia agreed withthe facts reported in the literature. Materials and methods: Patients’demographic features, such as age and gender, smoking and alcoholconsumption, and family history were recorded and retrospectively analyzed. In addition, the patency status of the pylorus, endoscopic metaplasia findings, pathologic findings (histopathologic features, biliary gastritis, Helicobacter pylori, atrophia, dysplasia, and intestinal metaplasia),type of intestinal metaplasia, and the presence of Helicobacter pyloriwere recorded and retrospectively analyzed. Results: A total of 217patients aged between 15 and 49 years were included in the study.Of all patients, 106 (48.8%) were males, and the mean age was foundas 33.23 ± 7.87 years. Eighty-eight (43.3%) of the participants weresmokers, and 46 (22.7%) used alcohol. Metaplasia was detected withendoscopy in 51 (23.5%) patients, while the pathology report indicatedmetaplasia in 72 (33.18%) patients. All metaplasia detected were of thecomplete type. Helicobacter pylori was positive in 85 (39.17%) patients,while the presence of Helicobacter pylori was pathologically confirmedin 75 (34.56%) of these patients. No significant difference was observedin between patients with and without metaplasia regarding Helicobacter pylori positivity, smoking and alcohol, age, gender, and familyhistory (p >0.05 for all). Conclusion: The incidence of intestinal metaplasia can be largely reduced by improving eating habits and makinglifestyle changes. Early detection and treatment of intestinal metaplasiais of paramount importance for reducing the incidence of gastric cancer
