Kolon polipleri: Lokalizasyon, histoloji, boyut - 5 yıllık kolonoskopik değerlendirme

Yıl 2018, Cilt: 26 Sayı: 2, 57 - 60, 25.09.2018

Yasin Şahintürk Ayhan Hilmi Çekin

https://doi.org/10.17940/endoskopi.461413

Cited By: 2

Öz

Giriş ve Amaç: Kolon polipleri konusunda hasta sayısı fazla olan
bir çalışma yaparak konu hakkındaki epidemiyolojik verilere prevalans,
histoloji, boyut ve lokalizasyon konusunda katkı yapmak. Gereç ve Yöntem: 2012-2017 yılları arasında kolonoskopi yapılan 2512
hasta kolon polip prevalansı, histolojisi (hiperplastik, adenomatöz, serrated),
boyutu (<1 cm
ve >1 cm)
ve lokalizasyonuna (rektum, sigmoid kolon, inen kolon, transvers kolon, çıkan
kolon, çekum) göre değerlendirildi. Bulgular:
Çalışmaya alınan 2.512 hastanın 876'sında (%34,9) polip saptandı. 104'ünde
(%11,9) hiperplastik polip saptanırken, 10 (%1,1) hastada serrated polip, 650
(%74,3) hastada adenomatöz polip saptandı. Saptanan poliplerin 696 (%79,4)
tanesi 1 cm'den
küçükken, 180 (%20,6) tanesi 1
cm'den büyüktü. Yerleşim bölgeleri incelendiğinde en sık
rektal bölgede 323 (%36,9) polipler saptanırken proksimal kolon kesimlerinde
polip görülme yüzdesi azalmaktaydı. Yaş arttıkça polip görülme sıklığı,
adenamatöz histoloji varlığı ve polip boyutu artmaktaydı. Erkeklerde polip
saptanma yüzdesi, kadınlarda ise >1 cm polip saptanma sıklığı  daha fazlaydı. Sonuç: Çalışmamız literatüre göre yüksek hasta sayısı içermesi
nedeniyle değerli sonuçlar içermektedir. Epidemiyolojik açıdan literatür
verilerine göre saptadığımız yüksek polip prevalansı tarama programlarında daha
dikkatli davranmamız gerektiğini düşündürmüştür.

Anahtar Kelimeler

Kolon polip, prevalans, histoloji, lokalizasyon, boyut

Colon polyps localization, histology, and size – five years of colonoscopic research

Öz

Background and Aims: We conducted a study with a
large number of  patients to contribute to the epidemiological information
in the literature on prevalence, histology, size, and localization of colon
polyps. Materials and Methods: Between 2012 and 2017, 2.512 patients
underwent colonoscopy to determine colon polyp prevalence, histology
(hyperplastic, adenomatous, and serrated), size (<1 cm and >1 cm), and
localization (rectum, sigmoid colon, descending colon, and transverse colon). Results:
Polyps were detected in 876 (34,9%) of 2.512
patients who were included in the study. Hyperplastic polyps were detected in
104 (11,9%) patients, serrated polyps in 10 (1,1%) patients, and adenomatous
polyps in 650 (74.3%) patients. Most (696, 79,4%) detected polyps were smaller
than 1 cm, but 180 (20,6%) were larger than 1 cm. According to the localization
of polyps, 323 (36,9%) were detected in the rectal region, whereas the
percentage of polyps in the proximal colon segments decreased. As age
increased, the incidence of polyps, adenomatous histology, and polyps
increased. When compared with that in females, the percentage of polyp
prevalence was higher in males. However, females had a higher rate of polyps
larger than 1 cm when compared with males. Conclusion: Our study
has meaningful results due to the high number of patients. In particular, the
high prevalence of polyps we detected according to data reported in the
literature should encourage all clinicians to establish a carefully executed
screening program.

Anahtar Kelimeler

Colon polyp, prevalence, histology, localization, size

Kaynakça

• 1) Shinya H, Wolff WI. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg 1979;190:679-83.
• 2) Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 2010;116:544-73.
• 3) Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 1975;15:617-31.
• 4) Locke FB, King H. Cancer mortality risk among Japanese in the United States. J Natl Cancer Inst 1980;65:1149-56.
• 5) Honda T, Kai I, Ohi G. Fat and dietary fiber intake and colon cancer mortality: a chronological comparison between Japan and the United States. Nutr Cancer 1999;33:95-9.
• 6) O’Brien MJ, Winawer SJ, Zauber AG, et al; National Polyp Study Workgroup. Flat adenomas in the National Polyp Study: is there increased risk for high-grade dysplasia initially or during surveillance? Clin Gastroenterol Hepatol 2004;2:905-11.
• 7) Schatzkin A, Lanza E, Corle D et al. Lack of effect of a low-fat, high fiber diet on the recurrence of colorectal adenomas. New Eng J Med 2000;342:1149-55.
• 8) Jass JR, Subsite distribution and incidence of colorectal cancer in New Zealand, 1974-1983. Dis Colon Rectum 1991;34:56-9.
• 9) Eminler AT, Sakallı M, Irak K, et al. Colonoscopic polypectomy results of our gastroenterology unit. Akademik Gastroenteroloji Dergisi 2011;10:112-5.
• 10) Dölek Y, Yuyucu Karabulut Y, Topal F, Kurşun N. Evaluation of gastrointestinal polyps according to their size, localization and histopathologic types. Endoskopi Dergisi 2013;21:31-5.
• 11) Bond JH. Polyp guideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 2000;95:3053-63.
• 12) Bingham SA, Day NE, Luben R. et al; European Prospective Investigation into Cancer and Nutrition. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet 2003;361:1496-501.
• 13) Terry MB, Neugut AI, Bostick RM, et al. Risk factors for advanced colorectal adenomas a pooled analysis. Cancer Epidemiol Biomarkers Prev 2002;11:622-9.
• 14) Giovannucci E. Epidemiologic studies of folate and colorectal neoplasia: a review. J Nutr 2002;132(8 Suppl):2350S-5S.
• 15) Morson B. Polyp-cancer sequence in large bowel. Proc R Soc Med 1974;67:451-7.
• 16) Hoff G, Foerster A, Vatn MH, et al. Epidemiology of polyps in the rectum and colon: recovery and evaluation of unresected polyps 2 years after detection. Scand J Gastroenterol 1986;21:853-62.
• 17) Pooler BD, Kim DH, Weiss JM, et al. Colorectal polyps missed with optical colonoscopy despite previous detection and localization with CT colonography. Radiology 2016;278:422-9.