Cansu ABAYLI, Figen DORAN, Bahri ABAYLI, Oğuz ÜSKÜDAR

On Yılı Kapsayan Duedonal Biyopsi Kayıtlarının Modifiye Marsh Klasifikasyonu

Amaç: Çöliak hastalığı, buğday, arpa ve yulaf gibi tahıllı gıdalarda bulunan, gluten proteinleri ile oluşan, toplumun %1 inden fazlasının etkilendiği, ince barsak enflamasyonu ile karekterize otoimmün bir hastalıktır. Çöliak hastalığında mukozal hasar, otoimmün kompenenti olan, aynı zamanda T hücre aracılı, kronik enflamatuvar hastalık olarak kabul edilen, dinamik bir süreçtir. Bu çalışmanın amacı, 10 yıl içerisinde bölümümüze gelen duedonal biopsilere Modifiye Marsh Klasifikasyonunu uygulamaktır. Bu çalışmanın amacı, daha önce tespit edilemeyen düşük dereceli çöliak olgularının ortaya çıkarılmasıdır. Materyal ve Metod: 467 biopsi alındı ve 2 patolog tarafından değerlendirildi (2001 ile 2011 yılları arasında Çukurova Üniversitesi Tıp Fakültesi, Patoloji anabilim dalında tanıları konuldu). Her bir örnek daha önce rapor edilen tanılar göz önüne alınmaksızın yeniden değerlendirildi. Bulgular: Modifiye Marsh Klasifikasyonuna göre 48 olgu Tip 1 çöliak tanısı konuldu. Modifiye Marsh Klasifikasyonuna göre 6 olguya Tip 2 çöliak tanısı konuldu. Toplam 11 olguya Modifiye Marsh Klasifikasyonuna göre Tip3a çöliak tanısı konuldu. Toplam 5 olguya Modifiye Marsh Klasifikasyonuna göre Tip 3b çöliak tanısı konuldu. Toplam 6 olguya Modifiye Marsh Klasifikasyonuna göre Tip 3c çöliak tanısı konuldu. Sonuç: Bu çalışma, Modifiye Marsh Klasifikasyonunun klinik şüpheli olgularda duedonal biopsilerin değerlendirilmesinde önemli bir standartizasyon getirdiğini, erken olguların değerlendirilmesinde çok yararlı olduğunu ortaya koymuştur.

Anahtar Kelimeler:

Modifiye Marsh klasifikasyonu, duodenal biyopsi, Çöliak hastalığı

Modified Marsh Classification of the Duodenal Biopsies of a Large Database Covering 10 Years

Purpose: Celiac is an autoimmune disease caused by of gluten proteins which can be found in multi-grain food like wheat, barley and oat. The disease affects more than 1% of population and characterized by intestinal inflammation. In celiac disease, mucosal damage is a dynamic process. It is shown that it has autoimmune components. It is also T-Cell mediated and can be categorised as a chronic inflammatory disease. The purpose of this study is to make modified Marsh classification of the duodenal biopsies that came to our department in the 10 years. The study deals with reassessment of all events and uncovering the low graded events that were not diagnosed. Material and Methods: 467 biopsies (diagnosed between 2001 and 2011 at the Cukurova University, Faculty of Medicine, Department of Pathology) were taken and analyzed by two pathologists. Each sample was reevaluated without taking the previous reports into consideration and scored by using modified Marsh classification. Results: According to Modified Marsh Classification total of 48 cases were diagnosed as Type 1. Total of 6 cases according to Modified Marsh Classification was diagnosed as Type 2. Total of 11 cases according to Modified Marsh Classification was diagnosed as Type 3a. Total of 5 cases, according to Modified Marsh Classification, was diagnosed as Type 3b. Total of 6 cases according to Modified Marsh Classification was diagnosed as Type 3c. Conclusion: As a result of this study, it has been found that Modified Marsh Classification is a very important standardization tool for detection of suspicious duodenal biopsies and for early case examinations.

Keywords:

Modified Marsh classification, duodenal biopsies, celiac disease,

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Yazışma Adresi / Address for Correspondence: Dr. Cansu Abaylı Çukurova University, Faculty of Medicine, Department of Pathology Sarıçam, ADANA Email: cabayli@mynet.com geliş tarihi/received :22.08.2013 kabul tarihi/accepted:24.09.2013