Gastrik Intestinal Metaplazi Sıklığı ve Helikobakter Pilori ile İlişkisinin Belirlenmesi

Öz

Amaç: Gastrik intestinal metaplazi (IM) mide kanserine giden yolda prekanseröz bir lezyondır. Helikobakter pilori (HP) non-kardia mide kanseri gelişiminde artış ile ilişkilendirilen, gastrik IM ile atrofik gastrit gelişiminde rol alan bir bakteridir. Bu çalışma ile dispepsi endikasyonu ile endoskopik inceleme yapılan hastalarda IM sıklığını ve HP ile ilişkisini belirlemeyi amaçladık. Materyal ve Metot: Çalışmada Ocak 2019-Ocak 2020 tarihleri arasında dispepsi nedeni ile Karadeniz Teknik Üniversitesi Farabi Hastanesi Gastroenteroloji Kliniği’nde üst gastrointestinal sistem endoskopisi yapılıp mide biyopsisi alınan 2530 hastanın yaş ve cinsiyet gibi demografik özellikleri ile biyopsi bulguları (IM, HP, atrofi, displazi varlığı) retrospektif taranarak değerlendirildi. Bulgular: Çalışmaya median yaşı 53 (18-93) yıl olan 1344 (%53,1) kadın ve 1186 (%46,9) erkek toplam 2530 olgu dahil edildi. Olguların %27,8’inde HP ve %26,8’inde de İM tespit edildi. İM pozitif olan 677 hastaların median yaşı 59 (19-92)yıl idi ve %29,7’si (n=352) erkekti. IM pozitif ve negatif gruplar içinde cinsiyetler arasında median yaş açısından anlamlı farklılık saptanmazken (Sırasıyla p=0,584, p=0,642), IM pozitif saptanan hastalarda median yaş ve erkek cinsiyet oranı IM negatif olanlara nazaran daha yüksekti (Sırasıyla p<0,001, p=0,002). Erkek hastalar arasında HP pozitiflik oranı %31 (n=368) iken aynı oran kadın hastalar arasında %24,9 (n=334) (p=0,001) idi. HP pozitif hastalarda erkek cinsiyet belirgin olarak daha yüksek idi (%52,4’e karşılık %47,6) HP pozitif olanlarda median yaş anlamlı olarak daha düşük idi p<0,001). IM pozitif ve negatif saptanan hasta grupları arasında HP pozitifliği açısından anlamlı farklılık saptanmadı (p=0,341). Sonuç: IM ileri yaşlarda ve erkek hastalarda daha fazla bulundu. HP pozitifliği erkek ve genç hastalarda daha fazla bulundu. IM ve HP sıklığı açısından anlamlı farklılık saptanmadı.

Anahtar Kelimeler

• intestinal metaplazi
• helikobakter pilori
• gastrik atrofi

Determination of the Frequency of Gastric Intestinal Metaplasia and Its Association with Helicobacter Pylori

Öz

Aim: Gastric intestinal metaplasia (IM) is a precancerous lesion in the pathway to gastric cancer. Helicobacter pylori (HP) is a bacterium that has been associated with an increase in the development of non-cardia gastric cancer and is involved in the development of gastric IM and atrophic gastritis. In this study, we aimed to determine the frequency of IM and its relationship with HP in patients undergoing endoscopic examination with the indication of dyspepsia. Material and Method: The study included 2530 patients who underwent upper gastrointestinal system endoscopy and had gastric biopsy at the Karadeniz Technical University Farabi Hospital Gastroenterology Clinic due to dyspepsia between January 2019 and January 2020. Demographic characteristics of the patients such as age and gender, biopsy findings (presence of IM, HP, atrophy, dysplasia) were evaluated retrospectively. Results: A total of 2530 cases, 1344 (53.1%) women and 1186 (46.9%) men, with a median age of 53 (18-93) years were included in the study. HP was detected in 27.8% of the cases and IM was detected in 26.8%. The median age of 677 patients with positive IM was 59 (19-92) years, and 29.7% (n=352) were male. While no significant difference was found between the sexes in terms of median age within the IM positive and negative groups (p=0.584, p=0.642, respectively), the median age and male sex ratio were higher in patients with IM positive than those with IM negative (p<0.001, p=0.002, respectively). While the rate of HP positivity among male patients was 31% (n=368), the same rate was 24.9% (n=334) among female patients (p=0.001). The male gender was significantly higher in HP positive patients (52.4% vs. 47.6%), and the median age was significantly lower in HP positive patients (p<0.001). There was no significant difference in HP positivity between IM positive and negative patient groups (p=0.341). Conclusion: IM was more common in older and male patients. HP positivity was found more frequently in male and young patients. No significant difference was found in the frequency of IM and HP.

Anahtar Kelimeler

• intestinal metaplasia
• helicobacter pylori
• gastric atrophy

Kaynakça

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