Prekanseröz lezyonların Helicobacter pylori eradikasyonuna olan etkisi

Year 2018, Volume: 17 Issue: 3, 117 - 122, 29.12.2018

Evrim Kahramanoğlu Aksoy Muhammet Yener Akpınar Ferdane Pirinççi Sapmaz Zeynep Göktaş Gülçin Güler Şimşek Metin Uzman Yaşar Nazlıgül

https://doi.org/10.17941/agd.502358

Abstract

Giriş
ve Amaç: Mide mukozasındaki Helicobacter pylori yoğunluğu, inflamasyonun aktivite derecesi,
gastrit şiddeti ile eradikayon başarısı arasındaki ilişkiyi gösteren çalışma
sayısı sınırlıdır. Biz çalışmamamızda; Helicobacter
pylori eradikasyon başarısı üzerine gastrit şiddetinin ve Sidney
klasifikasyon parametrelerinin etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya; Temmuz 2017
ve Aralık 2017 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi’nde Helicobacter pylori enfeksiyonu patoloji
olarak konmuş, eradikasyon için bizmut içeren standart dörtlü tedaviyi
tamamlayan hastalar dahil edildi. Bulgular:
Çalışmaya toplam 634 hasta dahil edildi. Antrumda atrofi varlığında Helicobacter pylori eradikasyon başarısı
düşükken, intestinal metaplazi varlığında eradikasyon başarısı etkilenmemiştir
(sırasıyla p=0,025 ve p >0,05); benzer şekilde korpustaki atrofi ve
intestinal metaplazi olan grupta da eradikasyon başarısı daha azdı (sırasıyla
p=0,016 ve p=0,01). Şiddetli gastrit gruplarında eradikasyon başarısızlığı daha
fazlaydı (OLGA III-IV için p=0.015, OLGIM III-IV için p=0.032). Multiple lineer
regresyon analizinde değerlendirildiğinde korpus intestinal metaplazi ve
lenfoid agregasyon şiddeti bağımsız risk faktörü olarak değerlendirilmiştir (sırasıyla
p=0.002 ve p=0.042). Sonuç: Gastrit
ciddiyeti, intestinal metaplazi ve gastrik atrofi Helicobacter pylori eradikasyon tedavisi başarısı üzerinde negatif
etki göstermektedir. Bu yüzden, patolojilerinde bu özelliklere sahip olan
hastalarda tedavi protokolü ve tedavi süresi yeniden gözden geçirilmelidir. 

Keywords

Atrofi, Helicobacter pylori, intestinal metaplazi

Precancerous lesions effects on the eradication of Helicobacter pylori

Abstract

Background
and Aims: There is limited data regarding the effect of
gastritis severity, the existence of atrophy, and intestinal metaplasia on the Helicobacter
pylori eradication. Herein we aimed to investigate the relationship between
Helicobacter
pylori eradication and histopathological parameters like gastritis
severity, intestinal metaplasia and/or atrophy, and the Sydney classification. Material and Methods:  Patients diagnosed with Helicobacter pylori gastritis
were enrolled in the study between July 2017 and December 2017. All patients
received standard quadruple therapy with bismuth salt. Results: In total, 634 patients were enrolled. The success of Helicobacter pylori eradication in the presence of
atrophy in the gastric antrum was low, while the eradication success
was not affected in the presence of intestinal metaplasia (p=0.025 and p >0.05,
respectively). Eradication success was lower in the group with
atrophy and intestinal metaplasia in the antrum (p=0.016 and p=0.01,
respectively). Eradication failure was higher in the group with severe
gastritis (p=0.015 for OLGA III-IV, p=0.032 for OLGIM III-IV). Intestinal
metaplasia in the corpus and severity of the lymphoid aggregation were
independent risk factors for treatment failure (p=0.002 and p=0.042,
respectively). Conclusion: Severity of gastritis,
intestinal metaplasia, and gastric atrophy had a negative effect on Helicobacter pylori eradication success. Treatment protocols and
duration should be carefully planned in patients with these features.

Keywords

Atrophy, Helicobacter pylori, intestinal metaplasia

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