The relationship between gastric preneoplastic findings and colon polyps

Yıl 2013, Cilt: 12 Sayı: 3, 108 - 112, 01.12.2013

İsmail Hakkı Kalkan Ferdane Sapmaz Sefa Güliter Pınar Atasoy

Öz

Background and Aims: There are conflicting data regarding the relationship of Helicobacter pylori infection and the development of colon polyp. Although it is known that gastric atrophy and intestinal metaplasia are gastric preneoplastic findings, to date, the relationship between these findings and colonic polyp development has not been studied sufficiently. In our two-center study, we aimed to study the association between gastric preneoplastic lesions and the occurrence of colonic polyp. Materials and Methods:The patients who admitted to the Gastroenterology Outpatient Clinics of Kırıkkale University Faculty of Medicine and Kırıkkale Yüksek Ihtisas Hospital from January 1, 2012 to September 1, 2012 and underwent routine colonoscopy and had gastric biopsies taken for Helicobacter pylori infection on esophagogastroduodenoscopy were enrolled in the study. Patient demographic data (gender and age), information on colon polyp characteristics (size, number of polyps, and histology), and the presence and density of Helicobacter pylori, gastric atrophy and intestinal metaplasia in gastric biopsies according to Sydney classification were recorded. Results:The study group included 150 patients (males: 93, 62,0%), and the mean age of the participants was 57,4±13,3 years. Fifty-one (34,0%) of the patients had at least one colon polyp. Gastric atrophy was an independent risk factor for the development of colon polyp and adenoma (odds ratio: 3,1 (p=0,01) and odds ratio: 3,2 (p=0,02), respectively). Total adenomatous polyp size and the density of gastric atrophy (p=0,04) and of intestinal metaplasia were positively correlated (p=0,01). The total number of colonic adenomas was positively correlated with the density of atrophy (p=0,01) and of intestinal metaplasia (p

Anahtar Kelimeler

Helicobacter pylori, gastric atrophy, intestinal metaplasia, colon polyp, adenoma

Gastrik preneoplastik bulguların kolon polibi ile ilişkisi

Öz

Giriş ve Amaç: Helicobacter pylori enfeksiyonu ile kolon polibi gelişimi
arasındaki ilişkiye yönelik çalışmalarda çelişkili sonuçlar elde edilmiştir.
Mide için preneoplastik olduğu bilinen atrofi ve intestinal metaplazi ile
kolon polibi gelişimi arasındaki ilişki ise henüz yeterince irdelenmemiş-
tir. İki merkezde yürütmüş olduğumuz çalışmada, gastrik preneoplastik
bulgu varlığı ile kolon polibi arasındaki ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntem: Kırıkkale Üniversitesi Tıp Fakültesi ve Kırıkkale
Yüksek İhtisas Hastanesi Gastroenteroloji polikliniklerine 01.01.2012 ile
01.09.2012 tarihleri arasında başvuraran hastalardan özofagogastroduodenoskopi
yapılarak Helicobacter pylori için biyopsi örneği alınan ve eş
zamanlı kolonoskopi işlemi yapılan olgular çalışmaya dahil edildi. Olguların
demografik özellikleri, polip saptanan olgularda polip karakteristikleri
(büyüklük, sayı, histoloji) ve özofagogastroduodenoskopik biyopsi
sonucuna göre gastrik atrofi-intestinal metaplazi ve Helicobacter pylori
pozitifliği Sydney klasifikasyonuna göre kaydedildi. Bulgular: Çalışmaya
yaş ortalaması 57,4±13,3 olan toplam 150 (93 erkek, %62,0) olgu
dahil edildi. Olguların 51’inde (%34,0) en az 1 kolon polibi mevcuttu.
Kolon polibi ve adenoma varlığı için atrofi [(Sırasıyla; OR:3,1 (p=0,01)
ve OR:3,2 (p=0,02)] bağımsız risk faktörü idi. Toplam adenomatöz polip
çapı atrofinin derecesi (p=0,04) ve intestinal metaplazinin derecesi
(p=0,01) ile, toplam adenom sayısı ise atrofinin derecesi (p=0,01), intestinal
metaplazinin derecesi (p

Anahtar Kelimeler

Helicobacter pylori, gastrik atrofi, intestinal metaplazi, kolon polibi, adenoma

Kaynakça

• Peek RM Jr, Blaser MJ. Helicobacter pylori and gastrointestinal tract adenocarcinomas. Nat Rev Cancer 2002;2:28-37.
• Schistosomes, liver flukes and Helicobacter pylori. IARC working group on the evaluation of carcinogenic risks to humans. Lyon, 7-14 June 1994. IARC Monogr Eval Carcinog Risks Hum 1994; 61:177-241.
• Azevedo NF, Huntington J, Goodman KJ. The epidemiology of Helicobacter pylori and public health implications. Helicobacter 2009;14(Suppl 1):1-7.
• Maggio-Price L, Treuting P, Zeng W, et al. Helicobacter infection is required for inflammation and colon cancer in SMAD3-deficient mice. Cancer Res 2006;66:828-38.
• Bell SJ, Chisholm SA, Owen RJ, et al. Evaluation of Helicobacter species in inflammatory bowel disease. Aliment Pharmacol Ther 2003;18:481-6.
• Jones M, Helliwell P, Pritchard C, et al. Helicobacter pylori in colorectal neoplasm: is there an aetiological relationship? World J Surg Oncol 2007;5:51.
• Rao VP, Poutahidis T, Ge Z, et al. Innate immune inflammatory response against enteric bacteria Helicobacter hepaticus induces mammary adenocarcinoma in mice. Cancer Res 2006;66:7395- 400.
• Thorburn CM, Friedman GD, Dickinson CJ, et al. Gastrin and colorec- tal cancer: a prospective study. Gastroenterology 1998;115:275- 80.
• Bulajic M, Stimec B, Jesenofsky R, et al. Helicobacter pylori in colorectal carcinoma tissue. Cancer Epidemiol Biomarkers Prev 2007;16:631-3.
• Siddheshwar RK, Muhammad KB, Gray JC, Kelly SB. Seropreva- lence of Helicobacter pylori in patients with colorectal polyps and colorectal carcinoma. Am J Gastroenterol 2001;96:84-8.
• Liou JM, Lin JW, Huang SP, et al. Helicobacter pylori infection is not associated with increased risk of colorectal polyps in Taiwanese. Int J Cancer 2006;119:1999-2000.
• Vannella L, Lahner E, Annibale B. Risk for gastric neoplasias in pa- tients with chronic atrophic gastritis: a critical reappraisal. World J Gastroenterol 2012;18:1279-85.
• Fujimori S, Kishida T, Kobayashi T, et al. Helicobacter pylori infec- tion increases the risk of colorectal adenoma and adenocarcinoma, especially in women. J Gastroenterol 2005;40:887-93.
• Shmuely H, Passaro D, Figer A, et al. Relationship between Helico- bacter pylori CagA status and colorectal cancer. Am J Gastroen- terol 2001;96:3406-10.
• Soylu A, Ozkara S, Alis H, et al. Immunohistochemical testing for Helicobacter pylori existence in neoplasms of the colon. BMC Gas- troenterol 2008;8:35.
• Grahn N, Hmani-Aifa M, Fransén K, et al. Molecular identification of Helicobacter DNA present in human colorectal adenocarcinomas by 16S rDNA PCR amplification and pyrosequencing analysis. J Med Microbiol 2005;54:1031-5.
• Abbass K, Gul W, Beck G, et al. Association of Helicobacter pylori infection with the development of colorectal polyps and colorectal carcinoma. South Med J 2011;104:473-6.
• Takeda H, Asaka M. Helicobacter pylori and colorectal neoplasm: a mysterious link? J Gastroenterol 2005;40:919-20.
• Konturek SJ, Konturek PC, Hartwich A, Hahn EG. Helicobacter py- lori infection and gastrin and cyclooxygenase expression in gastric and colorectal malignancies. Regul Pept 2000;93:13-9.
• Tatsu K, Hayashi S, Shimada I, Matsui K. Cyclooxygenase-2 in spo- radic colorectal polyps: immunohistochemical study and its impor- tance in the early stages of colorectal tumorigenesis. Pathol Res Pract 2005;201:427-33.
• Burkitt MD, Varro A, Pritchard DM. Importance of gastrin in the pathogenesis and treatment of gastric tumors. World J Gastroen- terol 2009;15:1-16.