Nisan 2025
Gaitada gizli kan pozitifligi nedeniyle kolonoskopi yapilan hastalarin kolonoskopi ve histopatoloji sonuçlarinin degerlendirilmesi
Evaluation of colonoscopy and histopathology results in patients undergoing colonoscopy for occult blood positivity in stool
- Ana Sayfa
- Sayılar
- Nisan 2025
- Gaitada gizli kan pozitifligi nedeniyle kolonoskopi yapilan hastalarin kolonoskopi ve histopatoloji sonuçlarinin degerlendirilmesi...
Antalya Sehir Hastanesi, 3Iç Hastaliklari Klinigi, Antalya
Özet
Giris ve Amaç: Kolorektal kanser taramasinda gaitada gizli kan testi ilk asamada siklikla kullanilan bir testtir. Gaita gizli kan disinda taramada fekal immünohistokimyasal test, sigmoidoskopi ve kolonoskopi gibi yöntemler kullanilmaktadir. Bu çalismada gaitada gizli kan testi pozitif olmasi nedeniyle kolonoskopi yapilan hastalarin kolonoskopi ve histopatoloji sonuçlarinin degerlendirilmesi amaçlanmistir. Gereç ve Yöntem: Bu çalismaya Ocak 2020 ile Aralik 2024 yillari arasinda Antalya Egitim ve Arastirma Hastanesi’nde gaitada gizli kan pozitifligi nedeniyle kolonoskopi yapilan hastalar dahil edildi. Kolon temizligi yetersiz olanlar, bilinen kolorektal kanser öyküsü ve inflamatuvar bagirsak hastaligi öyküsü olanlar dislandiktan sonra dahil edilen hastalarin yasi, cinsiyeti, kolonoskopi sonuçlari ve histopatoloji sonuçlari not edildi. Bulgular: Çalismaya toplamda 508 hasta dahil edildi. Hastalarin 260’i (%51.2) erkek, 248’i (%48.8) kadin, medyan yas 61 (20 - 95), medyan hemoglobin degeri 13.5 (5 - 16.3) g/dl idi. 196 (%38.6) hastanin kolonoskopi bulgulari normaldi. Diger kolonoskopi bulgulari; polip 107 (%21.1), inflamatuvar bagirsak hastaligi 70 (%13.8), perianal hastalik 59 (%11.6), kolorektal kanser 31 (%6.1), divertikül 26 (%5.1), ülser 15 (%3), anjiodisplazi 4 (0.8) hasta olarak not edildi. Kolonoskopi neticesinde kolorektal kanser düsünülen ve polip görülen 223 (%43.8) hastadan biyopsi örnegi alindi; adenomatöz polip 77 (%34.5), inflamatuvar bagirsak hastaligi 59 (26.5), adenokarsinom 31 (%13.9), hiperplastik polip 26 (%11.7) hastada saptandi. 30 (%13.5) hastada patolojik bulgu görülmedi. Sonuç: Gaita gizli kan testi pozitifligi nedeniyle kolonoskopi yapilan hastalarin neredeyse yarisinda kolonda bir patoloji tespit edilmistir. Gaita gizli kan testi kolorektal kanserlerin ve prekanseröz lezyonlarin tespitinde oldugu gibi, inflamatuvar ba- girsak hastaligi, divertikül, perianal hastalik gibi diger kolon patolojilerinin de tespit edilmesinde kullanilan yol gösterici, kolay uygulanabilir, ucuz bir testtir.
Abstract
Background and Aims: Fecal occult blood test is frequently used as a first-line screening method for colorectal cancer. In addition to fecal occult blood test, other screening methods include fecal immunohistochemical test, sigmoidoscopy, and colonoscopy. This study aims to evaluate the colonoscopy and histopathology results of patients who underwent colonoscopy due to a positive fecal occult blood test. Materials and Methods: This study included patients who underwent colonoscopy due to a positive fecal occult blood test at Antalya Training and Research Hospital between January 2020 and December 2024. Patients with inadequate bowel preparation, a known history of colorectal cancer, or inflammatory bowel disease were excluded. The age, gender, colonoscopy findings, and histopathological results of the included patients were recorded. Results: A total of 508 patients were included in the study, of whom 260 (51.2%) were male and 248 (48.8%) were female, with a median age of 61 years (range: 20 - 95). The median hemoglobin level was 13.5 g/dL (range: 5 - 16.3). Colonoscopy findings were normal in 196 (38.6%) patients. Other findings included polyps in 107 (21.1%), inflammatory bowel disease in 70 (13.8%), perianal disease in 59 (11.6%), colorectal cancer in 31 (6.1%), diverticula in 26 (5.1%), ulcers in 15 (3%), and angiodysplasia in 4 (0.8%) patients. A total of 223 (43.8%) patients with suspected colorectal cancer or polyps underwent biopsy. Histopathological examination revealed adenomatous polyps in 77 (34.5%) patients, inflammatory bowel disease in 59 (26.5%), adenocarcinoma in 31 (13.9%), and hyperplastic polyps in 26 (11.7%) patients, while 30 (13.5%) patients had no pathological findings. Conclusion: Nearly half of the patients who underwent colonoscopy due to a positive fecal occult blood test were found to have colonic pathology. Fecal occult blood test is a simple, cost-effective, and practical test not only for detecting colorectal cancer and precancerous lesions but also for identifying other colonic pathologies such as inflammatory bowel disease, diverticula, and perianal diseases.
