Levent ERDEM, Nihat AKBAYIR, Damlanur SAKIZ, CANAN ALKIM, H. Mehmet SÖKMEN, Çetin KARACA, Nedim POLAT

Dispepsili hastalarda midenin prekanseröz lezyonları ile karşılaşma riski

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.

Anahtar Kelimeler:

Dispepsi, mide, prekanseröz lezyon, H. pylori

The risk of encountering with gastric precancerous lesions in dyspeptic patients

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.

Keywords:

Dyspepsia, stomach, precancerous lesion, H. pylori,

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