Kolorektal Poliplerin Genel Özellikleri; Tek Merkez Sonuçları

Öz

Amaç: Kolorektal kanserlerin büyük çoğunluğunun kolon poliplerinden geliştiği kanıtlanmıştır. Bu nedenle kolon poliplerinin erken tespit tedavisi önem arz etmektedir. Bu yazıda kliniğimizde yapılan kolonoskopide tespit edilen poliplerin genel özelliklerini sunmayı amaçladık. Gereç ve Yöntem: Tokat Gaziosmanpaşa Üniversitesi Sağlık Araştırma Ve Uygulama Merkezi Merkezi Hastanesi Gastroenteroloji bölümünde kolonoskopi yapılan784 adet gastrointestinal polip olgusu retrospektif olarak incelendi, çalışma kriterlerini sağlayan 217 hasta çalışmaya alındı. Yerleşim özellikleri ve histopatolojik tiplerine göre polipler sınıflandırıldı. Bulgular: Polip tespit edilen hastaların % 65,9’u erkek, %34,1’i kadındı. Polipler %20,7 oranında en sık rektumda, en az %0,5 oranında splenik flexura yerleşimliydi. Olguların %83,9’unda (179 hasta) polipler sadece tek lokalizasyonda iken birden fazla lokalizasyonda polip bulunma oranı %16,1(38 hasta) olarak saptanmıştır. Histopatolojik olarak poliplerin %61,7’iadenomatöz, %33,2’sihiperplastik, %0,5’i adenokanser, geri kalan sıklık sırasına göre hamartamatoz, inflamatuar ve sesil polip olarak saptanmıştır. Adenomatöz polipler alt tiplerine göre %53,9 tübüler, %6,9 tübülovillöz %0,9 villöz tip olarak rapor edilmiştir. Sonuç: Kolorektal poliplerin sıklıkla rektosigmoid bölgede yerleştiği yaklaşık olarak üçte ikisi adenamatöz, üçte birinin hiperplastik karakterde olduğu tespit edilmiştir.

Anahtar Kelimeler

• Kolorektal kanserler,adenomatöz polip,saplı ve sapsız polip

General Properties of Colorectal Polyps; Single Center Results

Öz

Background/Aims:Colorectal cancers are the most common gastrointestinal malignancies. It is the third most common cancer in the World and one of the majör causes of cancer-related mortality in developed countries. The incidence and mortality of colorectal carcinoma is markedly different worldwide. Gastrointestinal polyps are lesions that may have proliferative and neoplastic potential, forming a mass by protruding into the lumen. In this study, it was aimed to document the general properties of the colorectal polyps which were diagnosed in colonoscopy scans in our center. Material and Methods: A total of 784 patients with gastrointestinal polyps who underwent colonoscopy in the Department of Gastroenterology, Tokat Gaziosmanpaşa University Health Researchand Application Center Hospital, were reviewed retrospectively and 217 patients were included in the study. Polyps were classified according to their histopathological types and location. Results: Patients with polyps; 65,9% male and 34,1% female. Polyps were most frequently 20.7% in rectum and at least 0.5% in splenic flexura. In 83.9% (179 patients) of the cases, polyps were found to be only localized in a single location, while polyps were found to be morethan 16.1% (38 patients). Histopathologically, the polyps were 61.7% adenomatous, 33.2% hyperplastic, 0.5% adenocarcinoma, andthe rest were hamartamatosis, inflammatory and acoustic polyps respectively. Adenomatous polyps were reported as 53.9% tubularand 6.9% tubulovillous 0.9% villous type according to their subtypes. Conclusion:In our study, we evaluated polyps of the lower gastrointestinal system and it wasf ound that our results were generally compatible with the literature.

Anahtar Kelimeler

• Colorectalcancers,adenomatous polyps,sessile serratedpolyps

Kaynakça

1. 1.Arnold M, Sierra MS, Laversanne M, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut Epub 2016 Jan 27.
2. 2.Ferlay J, ShinHr, Bray F, Et Al. Estimates Of World wide burden Of Cancer İn 2008: Globocan2008. Int J Cancer 2010;127:2893-917.
3. 3. Itzkowitz SH, Potack J. Colonic polyps and polyposis syndromes. In: Sleisenger MH, Fordtran JS, (Eds). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 8 th ed. Philedeplhia. Saunders. 2006; 271336.
4. 4.Trimbath JD, Giardiello FM. Reviewarticle: Genetic testing and counselling for hereditary colorectal cancers. Aliment Pharmacol Ther 2002;16:1843-57.
5. 5.Country-specific incidence and mortality rates are available from the World Health Organization Globocan database.
6. 6. Risio M. The natural history of adenomas. Best Pract Res Clin Gastroenterol 2010;24:271-80
7. 7. Paik JH, Jung EJ, Ryu CG, Hwang DY. Detection of polyps after resection of colorectal cancer. AnnColoproctol 2015;31:182-6.
8. 8.Brenner H, Hoffmeister M, Stegmaier C, et al. Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimatesbased on screening colonoscopies. Gut 2007;56:1585-9.

9. 9. Atkin WS, Morson BC, Cuzick J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med1992;326:658- 62.
10. 10.Konishi F, Morson BC. Pathology of colorectal adenomas: A colonoscopic survey. J ClinPathol 1982; 35: 830-41.
11. 11.Boland CR, Hzkowitz SH, Kim YS. Colonic polyps and gastrointestinal polyposis syndromes. Gastrointestinal disease, Sleisenger MH, Fordran JSS, Philadelphia, WB Saunders Company 1989; 2: 1483-518.
12. 13. MüllerAD, Sonnenberg A. Prevention of colorectal cancer by flexible endoscopy and polypectomy. A case-controlstudy of 32.702 veterans. Ann Intern Med 1995;123:904-10
13. 14. Winawer SJ, Zauber AG, Fletcher RH, et al, US Multi-Society Task Force on Colorectal Cancer; American Cancer Society. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006;130:1872-85.
14. 15. Eminler AT, Sakallı M, Irak K, et al. Gastroenteroloji ünitemizdeki kolonoskopik polipektomi sonuçlarımız. Akademik Gastroenteroloji Dergisi 2011; 10: 112-5.
15. 16. Williams Ar Balasorriya Ba, Day. Polyp And Cancer The Large Bowel 1982 Octb 23, 835-842
16. 17. Johansen LgMomsen O Jacobsen. No Polyp Of The Large İntestine İn Aarhus Denmark En Autopshy Study 1989 Sep , 799 -806
17. 18.Rex DK, Bond JH, Winawer S, et al. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-SocietyTask Force on ColorectalCancer. Am J Gastroenterol 2002; 97:1296.
18. 19.Atkin WS, Saunders BP, British SocietyforGastroenterology, Association of Coloproctology for Great Britain andIreland. Surveillance guidelines after removal of colorectal adenomatous polyps. Gut 2002; 51 Suppl5:V6.
19. 20.Bond JH. Polypguideline: diagnosis, treatment, and surveillance for patients with colorectal polyps. Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 2000; 95:3053.
20. 21.Lieberman DA, Weiss DG, Harford WV, et al. Five-year colon surveillance after screening colonoscopy. Gastroenterology 2007; 133:1077.
21. 22.Martínez ME, Baron JA, Lieberman DA, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology 2009; 136:832.
22. 23.Winawer SJ, Zauber AG, O'Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med 1993; 328:901.
23. 24.Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2012; 143:844.