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Antalya Bölgesinde Üçüncü Basamak Sağlık Kuruluşunda Endoskopi Yapılan Hastalarda Helicobacter Pylori Sıklığı ve Hastaların Demografik, Endoskopik ve Histopatolojik Özellikleri

Year 2017, Volume: 3 Issue: 2, 101 - 106, 01.01.2017

Abstract

Amaç: Helicobacter pylori H. pylori kronik gastrit, peptik ülser, atrofik gastrit, mide adenokanseri ve lenfoma gelişiminde etiyolojik bir ajandır. Gelişmekte olan ülkelerde prevalansı yüksektir. Çalışmamızda Antalya bölgesinde histopatolojik olarak H. pylori sıklığının saptanması ve hastaların klinik ve endoskopik bulguları ile eşlik eden atrofi, intestinal metaplazi ve displazi gibi bulguların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya değişik endikasyonlarla üst gastrointestinal sistem endoskopisi yapılan ve mide antrum ve korpus biyopsileri alınmış olan 262 hasta alındı. Hastaların patoloji raporları retrospektif olarak incelendi. Histopatolojik olarak H. pylori sıklığı belirlendi ve H. pylori pozitif ve negatif saptanan hastalar endoskopi endikasyonları, endoskopik bulgular ve histopatolojik özellikler açısından karşılaştırıldı. Bulgular: Hastaların %69,5’inde histopatolojik olarak H. pylori pozitifti. H. pylori pozitif grupta yaş ortalaması 46±14,70 yıl olup 104 kadın, 78 erkek hasta vardı. En sık endoskopi endikasyonu dispeptik şikayetlerdi ve H. pylori negatif gruptan farklı değildi p=0,79 . En sık endoskopik bulgu gastritti ve gruplar arasında anlamlı farklılık yoktu p=0,562 . H. pylori pozitif grupta özofajit sıklığı daha düşük, atrofi varlığı ise daha yüksek oranda bulundu ve bu bulgular istatistiksel olarak anlamlıydı Sırasıyla p=0,02 ve p=0,001 . İntestinal metaplazi, displazi açısından anlamlı farklılık bulunmadı Sırasıyla p=0,118 ve p=0,462 . Sonuç: Çalışmamızda özofajit sıklığı H. pylori pozitif hastalarda daha düşük bulunmuş ve bu durum H. pylori’nin gastroözofageal reflü hastalığına karşı koruyucu olabileceği yönündeki çalışmalarla uyumlu olarak değerlendirilmiştir. Atrofi H. pylori pozitif hastalarımızda negatif olanlara göre daha sık bulunmuş, bu bulgu da H. pylori’nin malignite gelişiminde önemli bir etken olduğunu destekler nitelikte olarak değerlendirilmiştir

References

  • Windsor HM, O’Rouke J. Bacteriology and taxonomy of Helicobacter pylori. Gastroenterol Clin North Am 2000; 29(3): 633-48.
  • Go MF, Crowe SE. Virulence and pathogenicity of Helicobacter pylori. Gastroenterol Clin North Am 2000; 29(3): 649-70.
  • Cohen H. Peptic Ulcer and Helicobacter Pylori. Gastroenterol Clin North Am 2000; 29(4): 775-89.
  • Fontham ETH, Ruiz B, Perez A. Determinants of Helicobacter pylori infection and chronic gastritis. Am J Gastroenterol 1995; 90(7): 1094-101.
  • Morgner A, Bayerdorffer E, Neubauer A, Stolte M. Malignant tumors of the stomach. Gastric mucosa- associated lymphoid tissue lymphoma and Helicobacter pylori. Gastroenterol Clin North Am 2000; 29(3): 593- 607.
  • Suerbaum S., Michetti P. Medical progress: Helicobacter pylori infection. N Engl J Med 2002; 347(15): 1175-86.
  • Megraud F. Epidemiology of H. Pylori infection. Gastroenterol Clin North Am 1993; 22(1): 73-88.
  • Özden A, Dumlu Ş, Dönderci Ö. Helicobacter Pylori infeksiyonun ülkemizde seroepidemiyolojisi. Gastroenteroloji 1992; 4: 665-8.
  • Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: A nationally- representative, cross-sectional, screening with the ¹³C-Urea breath test. BMC Public Health 2013; 13: 1215.
  • Ozdil K, Sahin A, Kahraman R. Current prevalence of intestinal metaplasia and Helicobacter pylori infection in dyspeptic adult patients from Turkey. Hepatogastroenterology 2010; 57: 1563–6.
  • Uyanıkoğlu A, Coşkun M, Binici DN. Endoskopi yapılan hastalarda Helicobacter pylori sıklığı. Dicle Med J 2012; 39: 197-200.
  • Demirtaş L, Sayar İ, Akbaş ME. Endoskopi yapılan hastalarda Helicobacter pylori sıklığı ve yerleşim yerinin yaş ve cinsiyete göre dağılımı. Dicle Med J 2014; 41 (3): 507-11.
  • Fareed R, Abbas Z, Shah MA. Effect of Helicobacter pylori density on inflammatory activity in stomach. J Pak Med Assoc 2000; 50(5): 148-51.
  • Selgrad M, Kandulski A, Malfertheiner P. Dyspepsia and Helicobacter pylori. Dig Dis 2008; 26(3): 210-4.
  • Watari J, Chen N, Amenta PS, Fukui H, Oshima T, Tomita T, Miwa H, Lim KJ, Das KM. Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development. World J Gastroenterol 2014; 20(18): 5461- 73.
  • Fallone CA, Barkun AN, Friedman G, Mayrand S, Loo V, Beech R, Best L, Joseph L. Is Helicobacter pylori eradication associated with gastroesophageal reflux disease? Am J Gastroenterol 2000; 95: 914-20.
  • Den Hollander WJ, Sostres C, Kuipers EJ, Lanas A. Helicobacter pylori and nonmalignant diseases. Helicobacter 2013; 18 Suppl 1: 24-7.
  • Eren M, Çolak Ö, Işıksoy S, Yavuz A. Effect of H. pylori infection on gastrin, ghrelin, motilin, and gastroesophageal reflux. Turk J Gastroenterol 2015; 26(5): 367-72.
  • Nguyen TL, Uchida T, Tsukamoto Y, Trinh DT, Ta L, Mai BH, Le SH, Thai KD, Ho DD, Hoang HH, Matsuhisa T, Okimoto T, Kodama M, Murakami K, Fujioka T, Yamaoka Y, Moriyama M. Helicobacter pylori infection and gastroduodenal diseases in Vietnam: A cross-sectional, hospital-based study. BMC Gastroenterol 2010; 10: 114.
  • Kurata JH, Nogawa AN. Meta-analysis of risk factors for peptic ulcers: Nonsteroidal anti-inflammatory drugs, Helicobacter pylori, and smoking. J Clin Gastroenterol 1997; 24: 2-17.
  • Wong CS, Chia CF, Lee HC, Wei PL, Ma HP, Tsai SH, Wu CH, Tam KW. Eradication of Helicobacter pylori for prevention of ulcer recurrence after simple closure of perforated peptic ulcer: a meta-analysis of randomized controlled trials. J Surg Res 2013; 182: 219-26.
  • Fischbach W, Chan A, Wong B. Helicobacter pylori and gastric malignancy. Helicobacter 2005; 10: 34-9.
  • Topal D, Göral V, Yilmaz F, Kara IH. The relation of Helicobacter Pylori with intestinal metaplasia, gastric atrophy and BCL-2. Turk J Gastroenterol 2004; 15(3): 149-55.
  • Olmez S, Aslan M, Erten R, Sayar S, Bayram I. The prevalence of gastric intestinal metaplasia and distribution of Helicobacter pylori infection, Atrophy, Dysplasia, and Cancer in its subtypes. Gastroenterol Res Pract 2015; 2015: 434039.
  • Nai GA, Parizi AC, Barbosa RL. Association between Helicobacter pylori concentration and the combining frequency of histopathological findings in gastric biopsies specimens. Arq Gastroenterol 2007; 44(3): 240-3.
  • Erdoğdu C, Saribaş Z, Akyön Yilmaz Y. Detection of cagA and vacA genotypes of Helicobacter pylori isolates from a university hospital in Ankara region, Turkey. Turk J Med Sci 2014; 44(1): 126-32.
  • Yakut M, Örmeci N, Erdal H, Keskin O, Karayel Z, Tutkak H, Soykan I. The association between precancerous gastric lesions and serum pepsinogens, serum gastrin, vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status. Clin Res Hepatol Gastroenterol 2013; 37(3): 302-11.

Helicobacter Pylori Prevalence and Evaluation of Demographic, Endoscopic and Histopathologic Findings of Patients in a Tertiary Center in the Antalya Region

Year 2017, Volume: 3 Issue: 2, 101 - 106, 01.01.2017

Abstract

Objective: Helicobacter pylori H. pylori is etiologically associated with chronic gastritis, peptic ulcer, atrophic gastritis, stomach adenocancer and lymphoma. Its prevalence is high in developing countries. In our study, we aimed to detect the prevalence of H. pylori and evaluate the clinical, endoscopic and histopathological findings such as atrophy, intestinal metaplasia and dysplasia in H. pylori positive patients. Material and Methods: 262 patients who underwent upper gastrointestinal endoscopy with biopsy from the antrum and corpus were included the study. Pathology reports were evaluated retrospectively. H. pylori prevalence was detected and endoscopy indications, endoscopic and histopathological findings were compared between H. pylori positive and negative groups. histopatolojik özellikler retrospektif olarak belirlendi ve H. pylori negatif hastalarla karşılaştırıldı.İstatistiksel analiz: Örneklemi tanımlamak için frekans dağılımı, ortalama, standart sapma gibi tanımlayıcı istatistikler kullanıldı. Kategorik veriler ise “ki-kare anlamlılık testi” ya da “Fisher’s Exact test” ile incelendi. Veriler PASW 20 SPSS/IBM, Chicago, IL, USA kullanılarak analiz edildi. Analizlerde farklılıkların belirlenmesi için %95 anlamlılık düzeyi ya da α=0.05 hata payı kullanılmıştır.Bu çalışmaya Akdeniz Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onay verilmiştir Etik Kurul onay tarih: 11.11.2015 - Karar numarası: 303 .BULGULAr results: 69.5% of the patients had H. pylori infection 104 women and 78 men, average age was 46±14.70 years . The most common endoscopic finding was gastritis and there was no statistically significant difference between the groups p=0,562 . Esophagitis was less prominent and atrophy was more common in H. pylori positive patients p=0.02 and p=0.001, respectively . Intestinal metaplasia and dysplasia were similar between the groups p=0.118 and p=0.462, respectively .conclusion: We found esophagitis to be less prominent in patients with H. pylori positivity. This finding is consistent with studies in the literature suggesting H. pylori infection may be protective against gastroesophageal reflux disease. Atrophy was found to be more frequent in patients with H. pylori positivity and this finding is consistent with the literature pointing out the role of H. pylori infection in malignant processes

References

  • Windsor HM, O’Rouke J. Bacteriology and taxonomy of Helicobacter pylori. Gastroenterol Clin North Am 2000; 29(3): 633-48.
  • Go MF, Crowe SE. Virulence and pathogenicity of Helicobacter pylori. Gastroenterol Clin North Am 2000; 29(3): 649-70.
  • Cohen H. Peptic Ulcer and Helicobacter Pylori. Gastroenterol Clin North Am 2000; 29(4): 775-89.
  • Fontham ETH, Ruiz B, Perez A. Determinants of Helicobacter pylori infection and chronic gastritis. Am J Gastroenterol 1995; 90(7): 1094-101.
  • Morgner A, Bayerdorffer E, Neubauer A, Stolte M. Malignant tumors of the stomach. Gastric mucosa- associated lymphoid tissue lymphoma and Helicobacter pylori. Gastroenterol Clin North Am 2000; 29(3): 593- 607.
  • Suerbaum S., Michetti P. Medical progress: Helicobacter pylori infection. N Engl J Med 2002; 347(15): 1175-86.
  • Megraud F. Epidemiology of H. Pylori infection. Gastroenterol Clin North Am 1993; 22(1): 73-88.
  • Özden A, Dumlu Ş, Dönderci Ö. Helicobacter Pylori infeksiyonun ülkemizde seroepidemiyolojisi. Gastroenteroloji 1992; 4: 665-8.
  • Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: A nationally- representative, cross-sectional, screening with the ¹³C-Urea breath test. BMC Public Health 2013; 13: 1215.
  • Ozdil K, Sahin A, Kahraman R. Current prevalence of intestinal metaplasia and Helicobacter pylori infection in dyspeptic adult patients from Turkey. Hepatogastroenterology 2010; 57: 1563–6.
  • Uyanıkoğlu A, Coşkun M, Binici DN. Endoskopi yapılan hastalarda Helicobacter pylori sıklığı. Dicle Med J 2012; 39: 197-200.
  • Demirtaş L, Sayar İ, Akbaş ME. Endoskopi yapılan hastalarda Helicobacter pylori sıklığı ve yerleşim yerinin yaş ve cinsiyete göre dağılımı. Dicle Med J 2014; 41 (3): 507-11.
  • Fareed R, Abbas Z, Shah MA. Effect of Helicobacter pylori density on inflammatory activity in stomach. J Pak Med Assoc 2000; 50(5): 148-51.
  • Selgrad M, Kandulski A, Malfertheiner P. Dyspepsia and Helicobacter pylori. Dig Dis 2008; 26(3): 210-4.
  • Watari J, Chen N, Amenta PS, Fukui H, Oshima T, Tomita T, Miwa H, Lim KJ, Das KM. Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development. World J Gastroenterol 2014; 20(18): 5461- 73.
  • Fallone CA, Barkun AN, Friedman G, Mayrand S, Loo V, Beech R, Best L, Joseph L. Is Helicobacter pylori eradication associated with gastroesophageal reflux disease? Am J Gastroenterol 2000; 95: 914-20.
  • Den Hollander WJ, Sostres C, Kuipers EJ, Lanas A. Helicobacter pylori and nonmalignant diseases. Helicobacter 2013; 18 Suppl 1: 24-7.
  • Eren M, Çolak Ö, Işıksoy S, Yavuz A. Effect of H. pylori infection on gastrin, ghrelin, motilin, and gastroesophageal reflux. Turk J Gastroenterol 2015; 26(5): 367-72.
  • Nguyen TL, Uchida T, Tsukamoto Y, Trinh DT, Ta L, Mai BH, Le SH, Thai KD, Ho DD, Hoang HH, Matsuhisa T, Okimoto T, Kodama M, Murakami K, Fujioka T, Yamaoka Y, Moriyama M. Helicobacter pylori infection and gastroduodenal diseases in Vietnam: A cross-sectional, hospital-based study. BMC Gastroenterol 2010; 10: 114.
  • Kurata JH, Nogawa AN. Meta-analysis of risk factors for peptic ulcers: Nonsteroidal anti-inflammatory drugs, Helicobacter pylori, and smoking. J Clin Gastroenterol 1997; 24: 2-17.
  • Wong CS, Chia CF, Lee HC, Wei PL, Ma HP, Tsai SH, Wu CH, Tam KW. Eradication of Helicobacter pylori for prevention of ulcer recurrence after simple closure of perforated peptic ulcer: a meta-analysis of randomized controlled trials. J Surg Res 2013; 182: 219-26.
  • Fischbach W, Chan A, Wong B. Helicobacter pylori and gastric malignancy. Helicobacter 2005; 10: 34-9.
  • Topal D, Göral V, Yilmaz F, Kara IH. The relation of Helicobacter Pylori with intestinal metaplasia, gastric atrophy and BCL-2. Turk J Gastroenterol 2004; 15(3): 149-55.
  • Olmez S, Aslan M, Erten R, Sayar S, Bayram I. The prevalence of gastric intestinal metaplasia and distribution of Helicobacter pylori infection, Atrophy, Dysplasia, and Cancer in its subtypes. Gastroenterol Res Pract 2015; 2015: 434039.
  • Nai GA, Parizi AC, Barbosa RL. Association between Helicobacter pylori concentration and the combining frequency of histopathological findings in gastric biopsies specimens. Arq Gastroenterol 2007; 44(3): 240-3.
  • Erdoğdu C, Saribaş Z, Akyön Yilmaz Y. Detection of cagA and vacA genotypes of Helicobacter pylori isolates from a university hospital in Ankara region, Turkey. Turk J Med Sci 2014; 44(1): 126-32.
  • Yakut M, Örmeci N, Erdal H, Keskin O, Karayel Z, Tutkak H, Soykan I. The association between precancerous gastric lesions and serum pepsinogens, serum gastrin, vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4 levels and Helicobacter pylori Cag A status. Clin Res Hepatol Gastroenterol 2013; 37(3): 302-11.
There are 27 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Aziz Kurtuluş This is me

Mete Akın This is me

Osman Çağın Buldukoğlu This is me

Tolga Yalçınkaya This is me

Bülent Yıldırım This is me

Mustafa Tekinalp Gelen This is me

Publication Date January 1, 2017
Published in Issue Year 2017 Volume: 3 Issue: 2

Cite

Vancouver Kurtuluş A, Akın M, Buldukoğlu OÇ, Yalçınkaya T, Yıldırım B, Gelen MT. Antalya Bölgesinde Üçüncü Basamak Sağlık Kuruluşunda Endoskopi Yapılan Hastalarda Helicobacter Pylori Sıklığı ve Hastaların Demografik, Endoskopik ve Histopatolojik Özellikleri. Akd Med J. 2017;3(2):101-6.