Gastrik Polipler: Beş Yıllık Tek Merkez Sonuçlarının Retrospektif Analizi

Yıl 2024, Cilt: 5 Sayı: 1, 14 - 18, 28.03.2024

Mehmet Sait Özsoy Mehmet Acar Furkan Kilic Hakan Baysal Fatih Büyüker Medeni Sermet Özgür Ekinci Orhan Alimoğlu

Öz

ÖZET:
Giriş: Gastrik polipler çoğunlukla asemptomatiktir, özofagogastroduodenoskopide rastlantısal olarak görülür ve çoğunlukla benign lezyonlardır. Kolon poliplerinden daha az görülürler ve daha düşük malign potansiyele sahiptirler. Tedavi planlamasının ana belirleyicisi polipin histopatolojik özellikleridir. Bu çalışmada, endoskopi ünitemizde saptanan gastrik poliplerin sıklığını, yaş, cinsiyet ve lokalizasyon dağılımını, histopatolojik özelliklerini, Helicobacter pylori (HP) ile ilişkisini ve intestinal metaplazi (İM) varlığını retrospektif olarak araştırmayı amaçladık.
Yöntemler: Ocak 2017 ile Ocak 2022 tarihleri arasında özofagogastroduodenoskopi yapılan 4004 hastanın endoskopi raporları retrospektif olarak incelendi. Histopatolojik polip saptanan 67 hastanın verileri değerlendirildi. Hastaların yaş, cinsiyet, endoskopik muayene bulguları ve histopatolojik verileri hastane kayıtlarından elde edildi ve retrospektif olarak değerlendirildi.
Bulgular: İncelene 4004 hastadan, 67(%1,67) kişide örneklenen lezyonlar histopatolojik olarak polip olarak değerlendirildi. Polip saptanan hastaların 41'i (%61,19) kadın ve 26'sı (%38,81) erkekti. Hastaların ortalama yaşı 60,28 (38-87) idi. Ortalama polip çapı 7,40 (3-60) mm idi. HP 58 hastanın 18'inde (%32,14) pozitifti. IM 56 hastanın 9'unda (%16,07) pozitifti. Bu hastaların 6'sında (%66,67) HP birlikteliği mevcuttu.
Sonuç: Özofagogastroduodenoskopide polip saptandığında biyopsi veya polipektomi yapılması, mide rezeksiyonlarında ise spesmende saptanan lezyonların histopatolojik olarak değerlendirilmesi önemlidir. Bu değerlendirmenin olası malignitelerin tespitine katkı sağlayacağı düşünülmektedir. Malignite gelişme potansiyeli nedeniyle polip saptanan hastaların HP ve IM varlığının araştırılmasının erken tanı ve tedaviye katkı sağlayacaktır.

Anahtar Kelimeler

gastrik polip, helicobacter pylori, intestinal metaplazi, malignite

Etik Beyan

Etik kurul onayı İstanbul Medeniyet Üniversitesi etik kurulundan 2022/0326 numarası ile alınmıştır.

Gastric polyps: A Retrospective Analysis of 5-Year Single Center Results

Öz

ABSTRACT:
Introduction: Gastric polyps are mostly asymptomatic, seen incidentally on oesophagogastroduodenoscopy and are mostly benign lesions. They are less common than colon polyps and have a lower malignant potential. The main determinant of treatment planning is the histopathological features of the polyp. In this study, we aimed to retrospectively investigate the frequency, age, gender and localisation distribution, histopathological features, association with Helicobacter pylori (HP) and the presence of intestinal metaplasia (IM) in gastric polyps detected in our endoscopy unit.
Methods: Endoscopy reports of 4004 patients who underwent oesophagogastroduodenoscopy between January 2017 and January 2022 were retrospectively reviewed. The data of 67 patients with histopathological polyps were evaluated. Age, gender, endoscopic examination findings and histopathological data of the patients were obtained from hospital records and evaluated retrospectively.
Results: The lesions sampled in 67 (1.67%) of 4004 patients were histopathologically evaluated as polyps. Of the patients with polyps, 41 (61.19%) were female and 26 (38.81%) were male. The mean age of the patients was 60.28 years (38-87). The mean polyp diameter was 7.40 (3-60) mm. HP was positive in 18 of 58 patients (32.14%). IM was positive in 9 of 56 patients (16.07%). HP coexistence was present in 6 (66.67%) of these patients.
Conclusion: It is important to perform biopsy or polypectomy when polyps are detected in esophagogastroduodenoscopy and histopathological evaluation of the lesions found in the specimen in gastric resections. This evaluation is thought to contribute to the detection of possible malignancies. Investigation of the presence of HP and IM in patients with polyps due to the potential for malignancy development will contribute to early diagnosis and treatment.

Anahtar Kelimeler

gastric polyp, helicobacter pylori, intestinal metaplasia, malignancy

Etik Beyan

Ethics committee approval was obtained from Istanbul Medeniyet University ethics committee with the number 2022/0326.

Kaynakça

• Referans1. Park DY, Lauwers GY. Gastric polyps: classification and management. Arch Pathol Lab Med. 2008; 132: 633-40.
• Referans2. Wang FW, Young SC, Chen RY, et al. The Prevalence and Risk Factors of Gastric Polyp in Asymptomatic Patients Receiving Health Examination. Gastroenterol Res Pract. 2018; 2018: 9451905.
• Referans3. Vos, S, van der Post, RS, Brosens, LAA. Gastric Epithelial Polyps: When to Ponder, When to Panic. Surg. Pathol. Clin.: 2020; 13: 431–52.
• Referans4. Goddard AF, Badreldin R, Pritchard DM., Walker MM, Warren B. The Management of Gastric Polyps. Gut 2010; 59: 1270–76.
• Referans5. Waldum H, Fossmark R. Gastritis, Gastric Polyps and Gastric Cancer. Int J Mol Sci. 2021;22: 6548.
• Referans6. Basnet, D. Makaju, R. Gurung, RB, Dhakal, R. Colorectal Polyps: A Histopathological Study in Tertiary Care Center. Nepalese Medical Journal. 2021; 4: 414-18.
• Referans7. Olmez S, Sayar S, Saritas B, et al. Evaluation of patients with gastric polyps. North Clin Istanb 2018;5: 41-46.
• Referans8. Carmack SW; The current spectrum of gastric polyps: a 1-year national study of over 120,000 patients, Am J Gastroenterol. 2009; 104: 1524-32.
• Referans9. Muehldorfer SM, Stolte M, Martus P, Hahn EG. Ell C. Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study. Gut. 2002; 50: 465–70.
• Referans10. 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: 117-22.
• Referans11. Fan NN, Yang J, Sun G, et al. Changes in the spectrum of gastric polyps in the Chinese population. World J Gastroenterol. 2015; 21: 9758-64.
• Referans12. 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. Journal of gastroenterology and hepatology.2012; 27: 1175-80.
• Referans13. Çiyiltepe H, Çetin DA, Gündeş E, et al. Endoscopic and histopathological features of the upper gastrointestinal system polyps: evaluation of 12.563 procedures. Turk J Surg. 2019;35: 98-104.
• Referans14. Yacoub H, Bibani N, Sabbah M, et al. Gastric polyps: a 10-year analysis of 18,496 upper endoscopies. BMC Gastroenterol. 2022; 22: 1: 1-7.
• Referans15. Han AR, Sung CO, Kim KM, et al. The Clinicopathological Features of Gastric Hyperplastic Polyps with Neoplastic Transformations: A Suggestion of Indication for Endoscopic Polypectomy. Gut and Liver 2009; 3: 271-75.
• Referans16. Kang HM, Oh TH, Seo JY, et al. Clinical factors predicting for neoplastic transformation of gastric hyperplastic polyps Korean J Gastroenterol. 2011; 58: 184-89.
• Referans17. Hizawa K, Fuchigami T, Iida M, et al. Possible neoplastic transformation within gastric hyperplastic polyp. Application of endoscopic polypectomy. Surg Endosc. 1995;9: 714–18.
• Referans18. Ahn, JY, Choi, KD, Roh, J, et al. Neoplasms arising in large gastric hyperplastic polyps: Endoscopic and pathologic features. Gastrointest Endosc 2014; 80: 1005-13.
• Referans19. Abraham, SC, Nobukawa, B, Giardiello, FM., Hamilton, SR., Wu, TT. Fundic gland polyps in familial adenomatous polyposis: neoplasms with frequent somatic adenomatous polyposis coli gene alterations. Am J Pathol 2000;157: 747-54.
• Referans20. Gullo I, Grillo F, Mastracci L, et al. Precancerous lesions of the stomach, gastric cancer and hereditary gastric cancer syndromes. Pathologica. 2020; 112: 166-85.
• Referans21. Gibson EG, Staub, J, Kanth P. Endoscopic Management of Hamartomatous Polyposis Syndromes. Curr Treat Options Gastro. 2021;19: 543–56.
• Referans22. Klimkowski S, Ibrahim M, Ibarra Rovira JJ, et al. Peutz–Jeghers Syndrome and the Role of Imaging: Pathophysiology, Diagnosis, and Associated Cancers. Cancers 2021; 13: 5121.
• Referans23. Modlin IM, Latich I, Zikusoka M, Kidd M, Eick G, Chan AK. Gastrointestinal carcinoids: the evolution of diagnostic strategies. J Clin Gastroenterol 2006; 40: 572– 82.
• Referans24. Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 2011; 40: 1–18.
• Referans25. Waldum H, Fossmark R. Gastritis, Gastric Polyps and Gastric Cancer. Int J Mol Sci. 2021;22: 6548.
• Referans26. Terada T. Malignant transformation of foveolar hyperplastic polyp of the stomach: a histopathological study. Med Oncol. 2011; 28: 941-4.
• Referans27. Jonaitis P, Kupcinskas L, Kupcinskas J. Molecular Alterations in Gastric Intestinal Metaplasia. Int. J. Mol. Sci. 2021; 22: 5758.
• Referans28. Lam, SK, Lau, G. Novel treatment for gastric intestinal metaplasia, a precursor to cancer. JGH Open 2020; 4: 569-73.
• Referans29. Zhang Y, Huang Q, Zhu LH, Zhou XB, Ye LP, Mao XL. Endoscopic excavation for gastric heterotopic pancreas: an analysis of 42 cases from a tertiary center. Wien Klin Wochenschr. 2014; 126:509-14.
• Referans30. Ahmed Y, Othman M. EMR/ESD: Techniques, Complications, and Evidence. Curr Gastroenterol Rep. 2020:15;22-39.