Fundik gland polipleri ile kolon polibi ve kolorektal kanser ilişkisi

Yıl 2019, Cilt: 52 Sayı: 3, 218 - 221, 21.12.2019

Hüseyin Köseoğlu Mustafa Tahtacı Murat Başaran Samet Yaman Tevfik Solakoğlu Öykü Tayfur Yürekli Aylin Demirezer Bolat Osman Ersoy

Öz

Amaç: Fundik glan polip (FGP) olan hastalarda kolorektal kanser ve kolorektal polip sıklığının artıp artmadığına dair çelişkili veriler mevcuttur. Bu çalışmanın amacı ülkemizdeki bir populasyonda FGP ile kolorektal neoplaziler arasındaki ilişkiyi ortaya koymaktır. Gereç ve yöntem: Bu çalışma retrospektif olarak yapılmış bir vaka-kontrol çalışmasıdır. Endoskopide FGP saptanan ve yakın zamanda kolonoskopi yapılmış olan hastalar FGP grubu olarak alındı. Endoskopide FGP saptanmayan ve endoskopi yapılan tarihe yakın kolonoskopi yapılmış olan hastalar kontrol grubu olarak çalışmaya dahhil edildi. Bulgular: FGP grubunda 50 vw kontrol grubunda 158 hasta çalışmaya dahil edildi. İki grup kıyaslandığında kolorektal polip sıklığının benzer olduğu izlendi, ancak FGP grubunda kolorektal kanser daha fazla saptandı. Cinsiyete göre alt grup analizi yapıldığında kadınlarda FGP grubunda kolorektal kanser riskinin artmış olduğu izlendi, ancak benzer bir ilişki erkeklerde saptanmamıştır. Sonuç: FGP olan kadın hastalarda kolorektal karsinom sıklığı FGP olmayan kadınlara göre daha fazladır.

Anahtar Kelimeler

kolon polip, kolonoskopi, kolorektal karsinom

The relationship between fundic gland polyp and colonic polyp or colorectal carcinoma

Öz

Purpose: Conflicting results are present whether colorectal carcinoma and colorectal polyps are more frequently detectable in patients with fundic gland polyp (FGP). The aim of this study was to evaluate the interaction between FGP and colorectal neoplasms in a Turkish population. Materials and methods: A retrospectively analyzed case-control study was performed. Patients with FGP who underwent also colonoscopy were classified as the FGP group, and patients who had no FGP on endoscopy and had a colonoscopy history within six months were classified as the control group. The colorectal polyp and colorectal carcinoma prevalence were compared between groups. Results: Fifty patients were included in the FGP group and 158 patients in the control group. There was no statistically significant difference between two groups according to colorectal polyp detection, but colorectal carcinoma was more frequently seen in patients with FGP. When female patients were included in the analysis patients with FGP had a higher prevalence for colorectal carcinoma. Similar difference was not detected in men. Conclusion: Colorectal carcinoma is more common in female patients with FGP compared to female patients without FGP. purpose: Conflicting results are present whether colorectal carcinoma and colorectal polyps are more frequently detectable in patients with fundic gland polyp (FGP). The aim of this study was to evaluate the interaction between FGP and colorectal neoplasms in a Turkish population. Materials and methods: A retrospectively analyzed case-control study was performed. Patients with FGP who underwent also colonoscopy were classified as the FGP group, and patients who had no FGP on endoscopy and had a colonoscopy history within six months were classified as the control group. The colorectal polyp and colorectal carcinoma prevalence were compared between groups. Results: Fifty patients were included in the FGP group and 158 patients in the control group. There was no statistically significant difference between two groups according to colorectal polyp detection, but colorectal carcinoma was more frequently seen in patients with FGP. When female patients were included in the analysis patients with FGP had a higher prevalence for colorectal carcinoma. Similar difference was not detected in men. Conclusion: Colorectal carcinoma is more common in female patients with FGP compared to female patients without FGP.

Anahtar Kelimeler

colonic polyps, colonoscopy, colorectal carcinoma

Kaynakça

• 1. Jalving M, Koornstra JJ, Wesseling J, Boezen HM, DE Jong S, Kleibeuker JH. Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy. Aliment Pharmacol Ther. 2006;24(9):1341-8. doi: 10.1111/j.1365-2036.2006.03127.x
• 2. Sonnenberg A, Genta RM. Prevalence of benign gastric polyps in a large pathology database. Dig Liver Dis. 2015;47(2):164-9. doi: 10.1016/j.dld.2014.10.004
• 3. Atalay R, Solakoğlu T, Ozer Sarı S, et al. Evaluation of gastric polyps detected by endoscopy: a single-center study of a four-year experience in Turkey. Turk J Gastroenterol. 2014;25(4):370-3. doi: 10.5152/tjg.2014.6705
• 4. Vatansever S, Akpınar Z, Alper E, et al. Gastric polyps and polypoid lesions: Retrospective analysis of 36650 endoscopic procedures in 29940 patients. Turk J Gastroenterol. 2015;26(2):117-22. doi: 10.5152/tjg.2015.7720
• 5. Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Avsar E, Sav A, Tozun N. Gastric polypoid lesions: analysis of 150 endoscopic polypectomy specimens from 91 patients . World J Gastroenterol. 2003;9(10):2236-9. doi: 10.3748/wjg.v9.i10.2236
• 6. Bertoni G, Sassatelli R, Nigrisoli E, et al. Dysplastic changes in gastric fundic gland polyps of patients with familial adenomatous polyposis. Ital J Gastroenterol Hepatol. 1999;31(3):192-7.
• 7. Teichmann J, Weickert U, Riemann JF. Gastric fundic gland polyps and colonic polyps - is there a link, really? Eur J Med Res. 2008;13(5):192-5.
• 8. Hwang SM, Kim BW, Chae HS, et al. Gastric Fundic Gland Polyps and Their Relationship to Colorectal Neoplasia in Koreans:A 16-year Retrospective Study. Korean J Gastroenterol. 2011;58(1):20-4. doi: 10.4166/kjg.2011.58.1.20
• 9. Cimmino DG, Mella JM, Luna P, et al. Risk of colorectal polyps in patients with sporadic gastric polyps: A case-control study. World J Gastrointest Endosc. 2013;5(5):240-5. doi: 10.4253/wjge.v5.i5.240
• 10. Genta RM, Schuler CM, Robiou CI, Lash RH. No Association Between Gastric Fundic Gland Polyps and Gastrointestinal Neoplasia in a Study of Over 100,000 Patients. Clin Gastroenterol Hepatol. 2009;7(8):849-54. doi: 10.1016/j.cgh.2009.05.015
• 11. Lee LS, Choi Y, Jung JY, et al. Do we need colonoscopy verification in patients with fundic gland polyp? Intest Res. 2016;14(2):172-7. doi: 10.5217/ir.2016.14.2.172
• 12. Elster K. Histologic classification of gastric polyps. Curr Top Pathol. 1976;65:77-93.
• 13. Stolte M, Sticht T, Ebert D, Ebert D, Finkenzeller G. Frequency, location, age and sex distribution of various types of gastric polyp. Endoscopy. 1994;26(8):659-65. doi: 10.1055/s-2007-1009061
• 14. Weston BR, Helper DJ, Rex DK. Positive predictive value of endoscopic features deemed typical of gastric fundic gland polyps. J Clin Gastroenterol. 2003;36(5):399-402. doi: 10.1097/00004836-200305000-00007
• 15. Goddard AF, Badreldin R, Pritchard DM, Walker MM, Warren B; British Society of Gastroenterology. The management of gastric polyps. Gut. 2010;59(9):1270-6. doi: 10.1136/gut.2009.182089
• 16. Randall GL, Randall WB. The histopathology of fundic gland polyps of the stomach. Am J Clin Pathol. 1986;86(4):498-503. doi:10.1093/ajcp/86.4.498
• 17. Stolte M, Vieth M, Ebert MP. High-grade dysplasia in sporadic fundic gland polyps: clinically relevant or not. Eur J Gastroenterol Hepatol. 2003;15(11):1153-6. doi: 10.1097/00042737-200311000-00001
• 18. Kishikawa H, Kaida S, Takarabe S, et al. Fundic gland polyps accurately predict a low risk of future gastric carcinogenesis. Clin Res Hepatol Gastroenterol. 2014;38(4):505-12. doi: 10.1016/j.clinre.2014.01.008
• 19. Declich P, Isimbaldi G, Sironi M, et al. Sporadic fundic gland polyps: an immunohistochemical study of their antigenic profile. Pathol Res Pract. 1996;192(8):808-15. doi: 10.1016/S0344-0338(96)80054-9
• 20. Dickey W, Kenny BD, McConnell JB. Prevalence of fundic gland polyps in a western European population. J Clin Gastroenterol. 1996;23(1):73–5. doi: 10.1097/00004836-199607000-00022
• 21. Kekilli M, Beyazit Y, Karaman K, et al. Endoscopic and pathological aspects of gastric polyps: a Turkish referral center study. Hepato-gastroenterology. 2012;59(116):1147-9. doi: 10.5754/hge10785
• 22. Cao H, Wang B, Zhang Z, Zhang H, Qu R. Distribution trends of gastric polyps: an endoscopy database analysis of 24 121 northern Chinese patients. J Gastroenterol Hepatol. 2012;27(7):1175-80. doi: 10.1111/j.1440-1746.2012.07116.x
• 23. Jung A, Vieth M, Maier O, Stolte M. Fundic gland polyps (Elster's cysts) of the gastric mucosa. A marker for colorectal epithelial neoplasia? Pathol Res Pract. 2002;198(11):731-4. doi:10.1078/0344-0338-00328
• 24. Leslie A, Carey FA, Pratt NR, Steele RJ. The colorectal adenoma-carcinoma sequence. Br J Surg. 2002;89(7):845-60. doi:10.1046/j.1365-2168.2002.02120.x
• 25. Ally MR, Veerappan GR, Maydonovitch CL, et al. Chronic proton pump inhibitor therapy associated with increased development of fundic gland polyps. Dig Dis Sci. 2009;54(12):2617-22. doi:10.1007/s10620-009-0993-z