BibTex RIS Kaynak Göster

The risk of encountering with gastric precancerous lesions in dyspeptic patients

Yıl 2005, Cilt: 4 Sayı: 2, 78 - 82, 01.08.2005

Öz

Background/aim: In the pathogenesis of intestinal type gastric cancer, the importance of the process of atrophic gastritis-intestinal metaplasiadysplasia- cancer is well known. In this study, assuming that it will provide a good database in gastric cancer follow-up programs, we intended to establish the rates of gastric precancerous lesion (atrophy, intestinal metaplasia, and dysplasia) in patients with dyspepsia. Materials and methods: From June 2003 - February 2004, 310 consecutive patients (172 females, 138 males, mean age 55.8, range 16-80) who applied for gastrointestinal endoscopy due to dyspepsia were included in the study. Five biopsies were taken from the antrum and corpus of these patients using the updated Sidney system and were examined histopathologically. Results: In these patients, we determined 8% (24 patients) with atrophic gastritis, 20% (61 patients) with intestinal metaplasia (complete or incomplete), and 4% (13 patients) with dysplasia. While H. pylori was (+) in 90% (89 patients) of 98 cases with precancerous lesions, H. pylori was (+) in 61% (115 patients) of 187 patients without precancerous lesions, and the difference was statistically significant. Conclusion: Several precancerous lesions may be detected in the stomach of patients in whom endoscopic examinations are performed due to dyspepsia. Verifying the strong relationship between intestinal type gastric cancers and H. pylori, this bacteria was found at a high rate in patients with precancerous lesions.

Kaynakça

  • Charles SF, Robert JM: Gastric carcinoma. N Eng J Med 1995; 6: 32-41.
  • Koh TJ, Wang TC: Tumors of the stomach. In Gastrointestinal and Liver disease. (Ed) Feldman M, Friedman LS, Sleisenger MH. WB Saunders Company, Philadelphia 2002; 829-55.
  • Correa P: Human gastric carcinogenesis: multistep and multifacto- rial process-first American Cancer Society Award Lecture on can- cer epidemiology and prevention. Cancer Res 1992; 52: 6735-40.
  • Fuchs C, Mayer R: Gastric carcinoma. N. Engl J Med 1995; 333: 32-41.
  • Kyrlagkitsis I, Karamanolis DG: Premalignant lesions and conditi- ons for gastric adenoacarcinoma: Diagnosis, management and sur- veillance guidelines. Hepatogastroenteroloy 2003; 50: 592-600
  • Der R, Chandrasoma P: Gastric neoplasms. In Chandrasoma P: Gastrointestinal Pathology, Stamford, Connecticut, Appleton&Lan- ge, 1999; 120-44.
  • Faraji EI, Frank BB: Multifocal atrophic gastritis and gastric car- cinoma. Gastroenterol Clin North Am Gastroenterology 2002; 31: 499-516.
  • Whiting JL, Sigurdsson A, Rowlands DC, et al: The long term re- sults of endoscopic surveillance of premalignant gastric lesions. Gut 2002; 50: 378-91.
  • Dıxon MF, Genta RM, Yardley JH, et al: Classification and grading of gastritis. The updated Sydney system. Am J Surg Pathol 1996; 20: 1161-81.
  • Rugge M, Correa P, Dixon M, et al: Gastric dysplasia: The Padova International Classification. Am J Surg Pathol 2000, 24: 167-76.
  • Yurdaydın C, Krastev Z, Bulajic M, et al. Güneydoğu Avrupa’da gastrointestinal sistem maligniteleri: 7 ülkenin katılımı ile çok ulus- lu çalışma. T. J. Gastroenterol 2002; 13 supp 1: 38 (Abst).
  • Hatemi İ, Erzin Y, Göksel S, et al. İntestinal metaplazi sıklığı, tiple- ri eşlik eden endoskopik bulgular. T. J Gastroenterol; 2004; 15 (Supp 1): 145 (Abst)
  • Özoran Y, Albayrak L, Turgutalp H, et al. Atrophic gastritis, intes- tinal metaplasia, gastric carcinoma and its variants in dispeptic ca- ses of eastern black sea region. 1992; J. İslamic Academy Sciences 5: 2: 118-22.
  • Lauwers GY, Riddell RH: Gastric epithelial dysplasia. Gut 1999; 45: 784-90.
  • Leung WK, Sung JJY: Review article: İntestinal metaplasia and gastric carcinogenesis. Aliment Pharmacol Ther 2002; 16: 1209-16.
  • Ribeiro MD, Lopes C, Pereira AC, et al. A follow up model for pa- tients with atrophic chronic gastritis and intestinal metaplasia. J Clin Pathol 2004; 57: 177-82.
  • International Agency for Research on Cancer: Anonymous live flu- kes and Helicobacter pylori. IARC Working Group on the Evaluati- on of Carcinogenic Risks to Humans. Lyon France: IARC Monogr Eval Carcinog Risks Hum 1994; 61: 1-241.
  • Correa P: Helicobacter pylori and gastric carcinonogenesis. Am J Surg Pathol. 1995; 19: 37-43.
  • Uemura N, Okamoto S, Yamamoto S, et al: Helicobacter pylori in- fection and the development of gastric cancer. New Engl J Med 2001; 345: 784-9.
  • Sepulveda AR, Graham DY: Role of Helicobacter pylori in gastric carsinogenesis. Gastroenterol Clin North Am 2002; 31: 517-35.
  • Buruk F, Berberoglu U, Pal I, et al: Gastric cancer and Helicobac- ter pylori infection. Br J Surg 1993; 80: 378-9.
  • Rood JC, Ruiz B, Fontham ETH, et al: Helicobacter pylori associ- ated gastritis and the ascorbic acid concentration in gastric juice. Nutrition and Cancer 1994; 22: 65-72.
  • Wong BCY, Lam SK, Wong WM, et al. Helicobacter pylori eradica- tion to prevent gastric cancer in a high-risk region of China. Jama 2004; 291: 187-94.
  • Mohar A, Ley C, Guarner J, et al: High frequency of precancerous lesions of gastric cancer associated with Helicobacter pylori and response to treatment, in Chiapas, Mexico. Gac. Med Mex 2002; 138(5): 405-10.

Dispepsili hastalarda midenin prekanseröz lezyonları ile karşılaşma riski

Yıl 2005, Cilt: 4 Sayı: 2, 78 - 82, 01.08.2005

Öz

Giriş ve amaç: İntestinal tip mide kanserinin patogenezinde atrofik gas trit-intestinal metaplazi-displazi- kanser sürecinin önemi bilinmektedir. Bu çalışmada mide kanser izlem programları içinde iyi bir veri tabanı sağlayabileceği öngörüsüyle dispepsili olgularda midedeki prekanseröz lezyon (atrofi, intestinal metaplazi, displazi) oranlarını belirlemeyi amaçladık. Gereç ve yöntem: Çalışmaya 2003 Haziran-2004 Şubat ayları arasında dispepsi nedeni ile üst gastrointestinal endoskopi yapılan ardı şık 285 hasta (161 kadın, 124 erkek, yaş ortalaması 55.8, yaş aralığı 16-80) alındı. Bu hastalardan güncelleştirilmiş Sidney sistemine göre antrum ve korpustan toplam 5 biyopsi alındı ve histopatolojik değerlendirme yapıldı. Bulgular: Bu hastaların %8'inde (24 hasta) atrofik gastrit, %21'inde (61 hasta) intestinal metaplazi (komplet ve inkomplet), %4'ünde (13 hasta) displazi saptandı. Mide kanseri için prekanseröz lezyonlar saptanan 98 olgunun %90'ında (89 hasta) H. pylori (+) iken, prekanseröz lezyon saptanmayan 187 olgunun ise %61'inde (115 hasta) H. pylori (+) bulundu ve istatiksel olarak anlamlı fark bulundu. Sonuç: Dispepsi nedeniyle üst gastrointestinal endoskopi yapılan hastalarda midenin prekanseröz lezyonları (atrofi, intestinal metaplazi, displazi) saptanabilir. İntestinal tip gastrik kanserle H. pylori arasındaki güçlü ilişkiyi doğrulayacak şekilde prekanseröz lezyon bulunan hastalarda bu bakteri yüksek oranda saptanmıştır.

Kaynakça

  • Charles SF, Robert JM: Gastric carcinoma. N Eng J Med 1995; 6: 32-41.
  • Koh TJ, Wang TC: Tumors of the stomach. In Gastrointestinal and Liver disease. (Ed) Feldman M, Friedman LS, Sleisenger MH. WB Saunders Company, Philadelphia 2002; 829-55.
  • Correa P: Human gastric carcinogenesis: multistep and multifacto- rial process-first American Cancer Society Award Lecture on can- cer epidemiology and prevention. Cancer Res 1992; 52: 6735-40.
  • Fuchs C, Mayer R: Gastric carcinoma. N. Engl J Med 1995; 333: 32-41.
  • Kyrlagkitsis I, Karamanolis DG: Premalignant lesions and conditi- ons for gastric adenoacarcinoma: Diagnosis, management and sur- veillance guidelines. Hepatogastroenteroloy 2003; 50: 592-600
  • Der R, Chandrasoma P: Gastric neoplasms. In Chandrasoma P: Gastrointestinal Pathology, Stamford, Connecticut, Appleton&Lan- ge, 1999; 120-44.
  • Faraji EI, Frank BB: Multifocal atrophic gastritis and gastric car- cinoma. Gastroenterol Clin North Am Gastroenterology 2002; 31: 499-516.
  • Whiting JL, Sigurdsson A, Rowlands DC, et al: The long term re- sults of endoscopic surveillance of premalignant gastric lesions. Gut 2002; 50: 378-91.
  • Dıxon MF, Genta RM, Yardley JH, et al: Classification and grading of gastritis. The updated Sydney system. Am J Surg Pathol 1996; 20: 1161-81.
  • Rugge M, Correa P, Dixon M, et al: Gastric dysplasia: The Padova International Classification. Am J Surg Pathol 2000, 24: 167-76.
  • Yurdaydın C, Krastev Z, Bulajic M, et al. Güneydoğu Avrupa’da gastrointestinal sistem maligniteleri: 7 ülkenin katılımı ile çok ulus- lu çalışma. T. J. Gastroenterol 2002; 13 supp 1: 38 (Abst).
  • Hatemi İ, Erzin Y, Göksel S, et al. İntestinal metaplazi sıklığı, tiple- ri eşlik eden endoskopik bulgular. T. J Gastroenterol; 2004; 15 (Supp 1): 145 (Abst)
  • Özoran Y, Albayrak L, Turgutalp H, et al. Atrophic gastritis, intes- tinal metaplasia, gastric carcinoma and its variants in dispeptic ca- ses of eastern black sea region. 1992; J. İslamic Academy Sciences 5: 2: 118-22.
  • Lauwers GY, Riddell RH: Gastric epithelial dysplasia. Gut 1999; 45: 784-90.
  • Leung WK, Sung JJY: Review article: İntestinal metaplasia and gastric carcinogenesis. Aliment Pharmacol Ther 2002; 16: 1209-16.
  • Ribeiro MD, Lopes C, Pereira AC, et al. A follow up model for pa- tients with atrophic chronic gastritis and intestinal metaplasia. J Clin Pathol 2004; 57: 177-82.
  • International Agency for Research on Cancer: Anonymous live flu- kes and Helicobacter pylori. IARC Working Group on the Evaluati- on of Carcinogenic Risks to Humans. Lyon France: IARC Monogr Eval Carcinog Risks Hum 1994; 61: 1-241.
  • Correa P: Helicobacter pylori and gastric carcinonogenesis. Am J Surg Pathol. 1995; 19: 37-43.
  • Uemura N, Okamoto S, Yamamoto S, et al: Helicobacter pylori in- fection and the development of gastric cancer. New Engl J Med 2001; 345: 784-9.
  • Sepulveda AR, Graham DY: Role of Helicobacter pylori in gastric carsinogenesis. Gastroenterol Clin North Am 2002; 31: 517-35.
  • Buruk F, Berberoglu U, Pal I, et al: Gastric cancer and Helicobac- ter pylori infection. Br J Surg 1993; 80: 378-9.
  • Rood JC, Ruiz B, Fontham ETH, et al: Helicobacter pylori associ- ated gastritis and the ascorbic acid concentration in gastric juice. Nutrition and Cancer 1994; 22: 65-72.
  • Wong BCY, Lam SK, Wong WM, et al. Helicobacter pylori eradica- tion to prevent gastric cancer in a high-risk region of China. Jama 2004; 291: 187-94.
  • Mohar A, Ley C, Guarner J, et al: High frequency of precancerous lesions of gastric cancer associated with Helicobacter pylori and response to treatment, in Chiapas, Mexico. Gac. Med Mex 2002; 138(5): 405-10.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Levent Erdem Bu kişi benim

Nihat Akbayır Bu kişi benim

Damlanur Sakız Bu kişi benim

Canan Alkım Bu kişi benim

H. Mehmet Sökmen Bu kişi benim

Çetin Karaca Bu kişi benim

Nedim Polat Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2005
Yayımlandığı Sayı Yıl 2005 Cilt: 4 Sayı: 2

Kaynak Göster

APA Erdem, L., Akbayır, N., Sakız, D., Alkım, C., vd. (2005). Dispepsili hastalarda midenin prekanseröz lezyonları ile karşılaşma riski. Akademik Gastroenteroloji Dergisi, 4(2), 78-82.

test-5