Evaluation of upper gastrointestinal system endoscopy screening in patients with acromegaly: a single center experience
Öz
Purpose: The prevalence of precancerous or cancerous lesions in the upper gastrointestinal tract in acromegalic patients is not well known. The aim of this study is to evaluate the endoscopic findings of the upper gastrointestinal system (GIS) of patients with acromegaly and to assess whether the pathological findings are related to the disease and the use of somatostatin analogs.
Materials and Methods: Between January 2010 and October 2021, patients diagnosed with acromegaly were identified by retrospective medical record scanning. This study included 49 patients with acromegaly who underwent upper GIS endoscopy. The acromegaly patients were divided into two groups: those who were taking somatostatin analogs at the time of endoscopy and those who were not. It was investigated whether there was a difference between these two groups in terms of lesion development. The patients with acromegaly and the control group were compared in terms of endoscopic findings and biopsy results.
Results: Of these patients, 53% (n=26) were male and 46.9% (n=23) were female. The incidence of Helicobacter pylori (HP) was significantly higher in the acromegaly patients than in the control subjects. In the acromegaly group, 62.5% (n=15) of the 24 patients with antral and pangastritis were taking somatostatin analogs. There was no significant difference between the use of somatostatin analogs and the development of gastritis. The development of esophagitis was statistically higher in patients with acromegaly taking somatostatin analogs.
Conclusion: The incidence of HP was higher in patients with acromegaly than in the normal population. No clear results were found regarding the development of gastritis. The incidence of esophagitis was high in acromegalic patients taking somatostatin analogs. Large-scale studies are needed to uncover the relationship between the etiology of the disease and the drugs taken.
Anahtar Kelimeler
Acromegaly, Esophagitis, Somatostatin analogs, Upper Gastrointestinal System Endoscopy.
Kaynakça
- Fernandez A, Karavitaki N, Wass JA. Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol (Oxf). 2010;72:377-82.
- Molitch ME. Clinical manifestations of acromegaly. Endocrinol Metab Clin North Am. 1992;21:597-614.
- Pivonello R, Auriemma RS, Grasso LF, Pivonello C, Simeoli C, Patalano R et al. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary. 2017;20:46-62.
- Bogazzi F, Cosci C, Sardella C, Costa A, Manetti L, Gasperi M et al. Identification of acromegalicpatients at risk of developing colonic adenomas. J Clin Endocrinol Metab. 2006;91:1351-6.
- Ron E, Gridley G, Hrubec Z, Page W, Arora S, Fraumeni JF Jr. Acromegaly and gastrointestinal cancer. Cancer. 1991;68:1673-7.
- J. Dal, M.Z. Leisner, K. Hermansen, D.K. Farkas, M. Bengtsen, C. Kistorp et al. Cancer incidence in patients with acromegaly: a cohort study and meta-analysis of the literature. J Clin Endocrinol. Metab. 2018;103:2182–8.
- Gomes-Porras M, Cárdenas-Salas J, Álvarez-Escolá C. Somatostatin analogs in clinical practice: a review. Int J Mol Sci. 2020;21:1682.
- Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99:3933-51.
- Hasegawa H, Onda M, Matsukura N, Naito Z, Maruyama H, Tokunaga A. Hemorrhagic gastric arcinoma in an acromegalic patient. J Nippon Med Sch. 2001;68:266–70.
- Dixon MF, Genta RM, Yardley JH, Correa P, Batts KP, Dahms BB et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol.1996;20:1161–81.
