Prevalence of gastric cancer precursor lesions in patients with dyspepsia

Year 2010, Volume: 37 Issue: 1, 25 - 29, 01.03.2010

Cem Aygün Elif Demirci Mine Çayırcı

Abstract

Objectives: In Southeastern cities of Turkey, high preva­lences of Helicobacter pylori infection and gastric cancer are seen. The aim of this study was to evaluate the fre­quency of the precancerous gastric lesions in patients with dyspeptic symptoms who underwent upper gastroin­testinal endoscopy in Adıyaman State Hospital. Materials and methods: We analyzed gastric biopsies taken from corpus and antrum of 234 consecutive pa­tients who underwent upper gastrointestinal endoscopy between January 2009 and May 2009. According to Syd­ney system, chronic gastritis, gastric atrophy, intestinal metaplasia and dysplasia were diagnosed by histological examination. Results: The mean age of patients was 46±15 (16- 82) years. Helicobacter pylori infection was seen in 66.7% of patients. Normal mucosa, chronic gastritis, gastric atro­phy, intestinal metaplasia and dysplasia were diagnosed in 2.7%, 78.6%, 3.4%, 11.5% and 3.8% of gastric biopsy specimens, respectively. Helicobacter pylori infected pa­tients showed a significantly higher prevalence of intes­tinal metaplasia compared with that of the non infected subjects (9.8% vs 1.7% p=0.021). Although prevalence of gastric atrophy and dysplasia were higher among He­licobacter pylori infected patients, the difference did not reached to a statistically significant level (3.0% vs 0.4% p=0.19 and 3.0% vs 0.8% p=0.37 respectively). Conclusion: Our findings suggested that the prevalence of gastric precancerous lesions such as gastric atrophy, intestinal metaplasia, dysplasia and Helicobacter pylori infection were high in dyspeptic patients. This may be re­lated to actual high incidence of gastric cancer in south­eastern region of Turkey.

Keywords

Dyspepsia, atrophic gastritis, intestinal meta­plasia, dysplasia, Helicobacter pylori.

Dispeptik yakınmalar ile başvuran hastalarda mide kanseri öncü lezyonlarının görülme sıklığı

Abstract

Amaç: Türkiye\'nin güneydoğusundaki illerde Helicobac­ter pylori enfeksiyonu ve mide kanseri oldukça sık görül­mektedir. Bu çalışma ile Adıyaman Devlet Hastanesinde dispeptik yakınmalar sebebiyle başvuran hastalarda mide kanseri öncü lezyonlarının görülme sıklığını değerlendir­mek amaçlanmıştır. Gereç ve yöntem: Ocak 2009 ile Mayıs 2009 tarihleri arasında dispeptik yakınmalar nedeni ile başvuran ardışık 234 hasta çalışmaya alınmıştır. Yapılan üst gastrointesti­nal sistem endoskopisi sırasında mide antrum ve korpus­dan biyopsiler alınarak, histopatolojik inceleme (Sydney sınıflaması) ile kronik gastrit, gastrik atrofi, intestinal me­taplazi ve displazi tanıları konulmuştur. Bulgular: İncelenen hastaların yaş ortalaması 46±15 (16-82) yıl idi. Alınan biyopsi örneklerinden, hastaların %66.7\'sinde Helicobacter pylori enfeksiyonu teşhis edildi. Histopatolojik incelemede; normal mukoza %2.7, kronik gastrit %78.6, gastrik atrofi %3.4, intestinal metaplazi %11.5 ve displazi %3.8 oranlarında görüldü. Helicobac­ter pylori enfeksiyonu olan hastalarda intestinal metaplazi görülme sıklığı Helicobacter pylori enfeksiyonu olmayan hastalara göre anlamlı oranlarda yüksekti (sırasıyla, %9.8 ile %1.7, p=0.021). Gastrik atrofi sıklığı (sırasıyla %3.0 ile %0.4 p=0.19) ve displazi sıklığı (sırasıyla, %3.0 ile %0.8 p=0.37) ise Helicobacter pylori enfeksiyonu olan hastalarda olmayanlardan daha yüksek olmakla beraber aradaki fark istatistiksel anlamlı düzeye ulaşmamaktaydı (p>0.05). Sonuç: Mide kanseri öncü lezyonları olan gastrik atrofi, intestinal metaplazi, displazi ile Helicobacter pylori en­feksiyonu dispeptik yakınmalar ile başvuran hastalarda sıklıkla görülmektedir. Bu durum Türkiye\'nin güneydoğu­sunda yüksek insidansda görülen mide kanseri ile ilgili olabilir.

Keywords

Dispepsi, atrofik gastrit, intestinal metaplazi, displazi, Helicobacter pylori.

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