Cerrahi ünitemizde yapılan kolonoskopik polipektomilerin histopatolojik sonuçları

Year 2017, , 62 - 65, 23.11.2017

Ayetullah Temiz , Abdülkadir Kaya

https://doi.org/10.17940/endoskopi.339849

Abstract

Giriş ve Amaç: Kolorektal kanserlerin %95’inden fazlası
adenomatöz polipten orijin alır. Kanserlerin büyük bir çoğunluğu normal
görünümlü mukozadan adenomaya, displaziye ve nihai olarak karsinoma geçiş
göstmektedir. Biz bu çalışmada cerrahi ünitemizde yapılan kolonoskopik
polipektomilerin histopatolojik özelliklerini irdelemeyi amaçladık. Gereç ve Yöntem: Erzurum Bölge Eğitim ve
Araştırma Hastanesi Cerrahi Endoskopi ünitesinde Ocak-2013 ile Aralık-2015
yılları arasında kolonoskopik polipektomi yapılan hastaların verileri bölümümüz
bilgi işlem veritabanından retrospektif olarak tarandı. Bulgular: Hastalarımızda polip görülme
oranı %16,1 idi. Hastaların 165’i (%63,5) erkek, 95’i (36,5) kadın idi. Yaş
ortalaması 60,87±13,1 (24-93) idi. Lokalizasyona göre polipler %42,1’i sigmoid
kolon ve %29,6’sı rektumda idi. Histopatolojik değerlendirmede, poliplerin
%49,5’i neoplastik polip idi. Bu poliplerin %40,2’si tübüler adenom, %4,4’ü
tübülovillöz adenom, %0,6’sı villöz adenom, %1,2’si intramukozal karsinom,
%3,1’i adenokarsinom idi. Adenomatöz poliplerin 52’sinde (%33) displazi
izlendi. Bunların 48’i (%92) düşük dereceli displazi, 4’ü (%3) yüksek dereceli
displazi idi. Polip çapı ile displazi arasında pozitif korelasyon izlendi
(p=0,038). Yüksek dereceli displazi görülen hastaların tümü 50 yaş üstü
hastalardı. Fakat genç hastalarda total displazi oranı daha yüksekti ve
istatistiksel olarak anlamlı idi (P=0,005). Sonuç: Biz bu çalışmada kanser öncüsü olan
adenomatöz poliplerde, literatür ile uyumlu olarak polip çapının displazi ile
pozitif korelasyon gösterdiğini, total displazinin genç hastalarda, yüksek
dereceli displazinin de yaşlı hastalarda daha yüksek olduğunu tespit ettik.

 

Keywords

Polip, adenom, displazi

Histopathological results of colonoscopic polypectomy in a surgery unit

Abstract

Background and Aims: More than 95% of colorectal cancers are of adenomatous polyps
origin. A large majority of cancers undergo a transition from normal-looking
mucosa to adenoma, dysplasia, and eventually carcinoma. In this study, we aimed
to investigate the histopathologic features of colonoscopic polypectomy
performed in our surgical unit. Materials and Methods: The data from patients who underwent colonoscopic
polypectomy between January 2013 and December 2015 in the surgical endoscopy
unit at Erzurum Regional Training and Research Hospital were scanned
retrospectively from our department data processing database. Results: The rate of polyps in our
patients was 16.1%. One hundred and sixty-five (63.5%) of the patients were
male, and 95 (36.5%) were female. The mean age was 60.87±13.1 years (24-93
years old). According to polyp location, 42.1% were in the sigmoid colon, and
29.6% were in the rectum. On histopathological evaluation, 49.5% of the polyps
were neoplastic polyps. Tubular adenomas were found in 40.2%, tubulovillous adenomas
in 4.4%, villous adenomas in 0.6%, intramucosal carcinomas in 1.2%, and
adenocarcinomas in 3.1% of these polyps. Dysplasia was observed in 52 (33%) of
adenomatous polyps. Of these, 48 (92%) were low-grade dysplasia, and 4 (3%)
were high-grade dysplasia. A positive correlation was observed between polyp
diameter and dysplasia (p=0.038). All of the patients with high-grade dysplasia
were over 50 years old. However, the rate of total dysplasia was higher in
younger patients and was statistically significant (p=0.005). Conclusion: In this study, we found that
polyp diameter correlates positively with dysplasia in adenomatous polyps,
which are cancer precursors, and that total dysplasia is higher in young
patients and high-grade dysplasia in elderly patients.

Keywords

Polyp, adenoma, dysplasia

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