Nisan 2021
Mide hiperplastik polipleri ve öncül lezyonlarinin degerlendirilmesi
Evaluation of gastric hyperplastic polyps and their precursor lesions
- Ana Sayfa
- Sayılar
- Nisan 2021
- Mide hiperplastik polipleri ve öncül lezyonlarinin degerlendirilmesi...
Özet
Giris ve Amaç: Mide poliplerinin yaklasik %75-90 kadarini hiperplastik polipler olusturur. Kronik inflamasyon nedenli epitelin asiri rejenerasyonuna bagli, faveolar hiperplazi ve kronik gastrit sonrasinda bu öncül lezyonlardan hiperplastik polipler olusur. Bu çalismada mide hiperplastik polipler ve öncül lezyonlarinin Helicobacter pylori ile iliskisi ve bu lezyonlarin intestinal metaplazi, atrofi durumlarinin literatür bilgileri esliginde tartisilmasi amaçlanmistir. Gereç ve Yöntem: Mus Devlet Hastanesi Endoskopi ünitesinde Ocak 2016-Ocak 2020 tarihleri arasinda özofagogastroduodenoskopi yapilan 7903 hastadan endoskopik görünümü polipoid yapida olan 172 hastanin histopatolojileri degerlendirildi. Hastalarin yasi, cinsiyeti, basvuru sikâyeti, polipoid görünümlü lezyonun yeri, lezyonlarin histopatolojik tipi kaydedildi. Bulgular: 172 hastaya polipektomi yapildi. Hastalarin 71’i erkek (%41.2), 101’i kadin (%58.8) olup, yas ortalamalari 49.4 ± 15 (19-83) yildi. Hastalar reaktif polipoidlezyonlar; foveolar hiperplazi 57 hasta, kronik gastrit 53 hasta ve gerçek polipoid 62 hasta (en sik hiperplastik polip 47 hasta %75) olarak iki gruba ayrildi. Polipoid görünümlü lezyonlar en fazla antrumda lokalize idi. Hastalarin basvuru sikayeti her iki grupta en fazla dispepsi idi. Gerçek polip lezyonlarinin çapi, reaktif polipoid lezyonlarin çapindan istatistiksel olarak büyük saptandi (p < 0.05). Helicobacter pylori orani reaktif polipoid grupta istatistiksel olarak daha yüksek bulundu (p < 0.05). Intestinal metaplazi ve atrofi durumu açisindan fark saptanmadi (p > 0.05). Sonuç: Hiperplastik polipler ve öncül lezyonlarinin prekanseröz durumlar olan atrofi ve intestinal metaplazi oranlari arasinda anlamli fark saptanmamistir. Bu yüzden endoskopide saptanan lezyonlardan tani ve displazinin varligini saptamak için biyopsi alinmali ya da eksize edilmeli ve Helicobacter pylori saptanan hastalar tedavi edilmelidir.
Abstract
Background and Aims: Approximately 75-90% of gastric polyps are comprised of hyperplastic polyps formed by precursor lesions after foveolar hyperplasia and chronic gastritis due to excessive epithelial regeneration caused by chronic inflammation. In this study, we discuss the relationship between gastric hyperplastic polyps and precursor lesions and Helicobacter pylori as well as intestinal metaplasia and the atrophy states of these lesions in light of the literature. Material and Methods: Among 7,903 patients who underwent esophagogastroduodenoscopy at Mus State Hospital between January 2016 and January 2020, 172 with an endoscopic view of polypoid structures were included and histopathologically examined. Data including age, sex, admission complaint, location of the polypoid lesion, and histopathological type were recorded. Results: The patients [101 females (58.8%); age, 49.4 ± 15 (19–83) years] underwent polypectomy. They were divided into the reactive polypoid group (57 patients with reactive foveolar hyperplasia and 53 with reactive chronic gastritis) and the actual polypoid group (62 patients; hyperplastic polyps in 47). Polypoid lesions were most often localized in the antrum. The most common complaint on admission was dyspepsia. The diameter of the actual polypoid lesions was significantly larger than that of the reactive polypoid lesions. The rate of Helicobacter pylori infection was significantly higher in the reactive polypoid group than in the actual polyploid group. Conclusions: No significant differences were observed in the prevalence of intestinal metaplasia and atrophy or between the rates of atrophy and intestinal metaplasia (precancerous condition of the hyperplastic polyps and their precursor lesions). Therefore, biopsy or excision of endoscopically detected lesions should be performed to diagnose dysplasia. Patients should be treated for Helicobacter pylori.
