Esin ATİK, Bülent KANTARÇEKEN, Ertan BÜLBÜLOĞLU, Ali ÇETİNKAYA

Helikobakter pilori pozitif ve negatif hastalarda intestinal metaplazi ve displazi sıklığı

Giriş ve amaç: Rutin üst gastrointestinal endoskopi için refere edilen H. pylori pozitif ve negatif dispeptik hastalarda intestinal metaplazi ve displazi sıklığını karşılaştırmak. Gereç ve yöntem: 141 dispeptik hasta çalışıldı (Yaş ortalaması 44.7+16 yıl, yaş aralığı 16-87 yıl, 62 erkek ve 79 kadın). Histolojik olarak H. pylori, intestinal metaplazi ve displazinin saptanması için antrum ve korpustan biyopsiler alındı. Bulgular: 141 hastanın 96'sı (%68.1) H. pylori pozitif idi. Intestinal metaplazi ve displazi sırasıyla H. pylori pozitif hastaların %42.7 (41/96) ve %5.2'sinde (5/96) ve H. pylori negatif hastaların %37.7 (17/45) ve %4.4'ünde (2/45) bulundu (p>0.05). Intestinal metaplazisi olan hastaların %70,7'si (41/58) ve displazisi olan hastaların %71.4'ü (5/7) H. pylori pozitif idi (p>0.05). Sonuç: H. pylori pozitif ve negatif hastalar arasında intestinal metaplazi ve displazi sıklığı yönünden istatistiksel olarak anlamlı farklılık yoktu, ancak intestinal metaplazisi ve displazisi olan hastalardaki yüksek orandaki H. pylori varlığı dikkat çekiciydi.

Anahtar Kelimeler:

Metaplazi, Dispepsi, Bağırsak hastalıkları, Helicobacter pylori

The frequency of intestinal metaplasia and dysplasia among Helicobacter pylori positive and negative patients

Background/aim: To compare the frequency of intestinal metaplasia and dysplasia in H. pylori-positive and negative dyspeptic patients referred for routine upper gastrointestinal endoscopy. Materials and methods: One hundred and forty-one dyspeptic patients were studied (average age 44.7+16 years, range 16-87 years, 62 males and 79 females). Antrum and corpus biopsies were taken for detection of H. pylori, intestinal metaplasia and dysplasia histologically. Results: There were 96 H. pylori-positive patients in 141 patients (68.1%). Intestinal metaplasia and dysplasia were found in 42.7% (41/96) and 5.2% (5/96) among the H. pylori-positive patients and in 37.7% (17/45) and 4.4% (2/45) among the H. pylori-negative patients, respectively (P>0.05). 70.7% (41/58) of the patients with intestinal metaplasia and 71.4% (5/7) of the patients with dysplasia were H. pylori- positive, respectively (P>0.05). Conclusions: There was no statistically significant difference in the frequency of intestinal metaplasia and dysplasia between the patients who were H. pylori-positive and -negative, but the high ratio of H. pylori among the patients with intestinal metaplasia and dysplasia warrants attention.

Keywords:

Metaplasia, Dyspepsia, Intestinal Diseases, Helicobacter pylori,

PDF

___

1.Yang YL, Xu B, Song YG, et al. Overexpression ofc-fos in Helicobacter pylori induced gastric precancerosis of Mongolian gerbil.World J Gastroenterol 2003; 9 (3): 521-24.
2.Logan RPH, Walker MM. Epidemiology and diagnosis of Helicobacter pylori infection. British Medical Journal 2001; 323: 920-22
3.Mills SE. Sternberg's Diagnostic Surgical Pathology; 4th ed. India:Lippincott Williams and Wilhins, 2004.
4.Guo DL, Dong M, Wang L, et al. Expression of gastric cancer-associated MG7 antigen in gastric cancer, precancerous lesions and H.pylori-associated gastric diseases. World J Gastroenterol 2002; 8(6): 1009-1013.
5.Liu WZ, Zheng X, Shi Y, et al. Effect of Helicobacter pylori infection on gastric epithelial proliferation in progression from normal mucosa to gastric carcinoma. World J Gastroenterol 1998; 4(3):246-48.
6.Gao HJ, Yu LZ, Bai JF, et al. Multiple genetic alterations and behavior of cellular biology in gastric cancer and other gastric mucosal lesions: H. pylori infection, histological types and staging. World J Gastroenterol 2000; 6(6): 848-54.
7.Yu J, Leung WK, Go MYY, et al. Relationship between Helicobacter pylori babA2 status with gastric epithelial cell turnover and premalignant gastric lesions. Gut 2002; 51: 480-84.
8.El-Zimaity HMT, Ramchatesingh J, Saeed MA, et al. Gastric intes tinal metaplasia: Subtypes and natural history. Journal of Clinical Pathology 2001; 54: 679-83.
9.Dixon ME, Genta RM, Yardley JH, Classification and grading of gastritis: the updated Sydney System, international workshop on the histopathology of gastritis, Houstan 1994. Am J Surg Pathol 1996;20: 1161-1181.
10.Rosai J. Rosai and Ackerman's Surgical Pathology; 9"' ed. China:Mosby, Elsevier, 2004.
11.Chen XY, van der Hulst RWM, Shi Y, et al. Comparison of precancerous conditions: Atrophy and intestinal metaplasia in Helicobacter pylori gastritis among Chinese and Dutch patients. Journal of Clinical Pathology 2001;54:367-70.
12.Meining A, Riedl B, Stolte M. Features of gastritis predisposing to gastric adenoma and early gastric cancer. Journal of Clinical Pathology 2002;55:770-74.
13.Chen XY, van der Hulst RWM, Bruno MJ. Interobserver variation in the histopatholgical scoring of Helicobacter pylori related gastritis.Journal of Clinical Pathology 1999; 52: 612-15.
14.Topal D, Göral V, Yılmaz F, et al. The relation of Helicobacter pylori with intestinal metaplasia, gastric atrophy and BCL-2. The Turkish Journal of Gastroeneterology 2004; 15 (3): 149-155.
15.Taşkın V, Sedele M, Saka O, et al. The effect of duodenogastric reflux on Helicobacter Pylori presence and gastric histopathologicchanges. The Turkish Journal of Gastroeneterology 2003; 14 (4):239-242.
16.Bravo JC, Correa P. Sulphomucins favour adhesion of Helicobacter pylori to metplastic gastritle mucosa. Journal of Clinical Pathology 1999; 52:137-40.
17.İkeno T, Ota H, Sugiyama A, et al. Helicobacter pylori-induced chronic active gastritis, intestinal metaplasia and gastric ulcer in Mongolian gerbils. American Journal of Pathology 1999; 154: 951-60.