Arif Hakan DEMİREL, Ali Ulvi ÖNGÖREN, Murat KAPAN, Muzaffe ÇAYDERE, Hüseyin ÜSTÜN

Mide kanseri ve mide lenfomasında Helikobakter pilori sıklığı

Giriş ve amaç: Mide malignitelerinde Helikobakter pilori sıklığının tanı mlanması ve etiyolojideki değerinin saptanması amaçlanmıştır. Helikobakter pilori enfeksiyonu gastrik adenokarsinom ve gastrik lenfoma riskinde artışla ilişkilidir. Gereç ve yöntem: 1998-2005 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesi 2. ve 5. Genel Cerrahi Klinikleri'nde malignite nedeniyle total ve subtotal mide rezeksiyonu yapılan 42 hastanın gastrik spesimenleri retrospektif olarak tekrar incelendi. Histolojik değerlendirme Lauren's klasifikasyonu ve Helikobakter pilori yoğunluk tayini için Sydney klasifikasyonu kullanıldı. Bulgular: Çalışmaya 32 gastrik karsinoma, 10 non-Hodgkin gastrik lenfoma vakası alındı. Helikobakter enfeksiyonu; gastrik karsinomlu hastaların 10'unda (%33.3), gastrik lenfomalı hastaların 7'sinde (%70) saptandı. Helikobakter yoğunluğu 9 gastrik karsinomlu, 7 gastrik lenfomalı hastada ‘1' iken, 1 gastrik karsinom vakasında ve 1 gastrik lenfomalı hastada yoğunluk ‘2' idi. Mide lenfoması vakalarında Helikobakter pilori prevalansı anlamlı olarak daha yüksek idi. Helikobakter pilori, intestinal tip gastrik karsinoma nazaran difüz gastrik karsinomada daha sık görüldü. Ayrıca gastrik karsinom klinik evresi arttıkça Helikobakter pilori yoğunluğu da artmakta birlikte istatistiksel olarak bu bulgular anlamlı bulunmadı. Sonuç: Gastrik maligniteler arasında lenfoma olgularında yüksek sıklıkta Helikobakter pilori bulunması gastrik lenfomanın oluşmasında Helikobakter pilori'nin rolünü doğrulamaktadır.

Anahtar Kelimeler:

Helikobakter pilori, gastrik karsinoma, gastrik lenfoma

Helicobacter pylori prevalance in gastric carcinoma and gastric lymphoma

Background/aim: We aimed to determine Helicobacter pylori prevalence in gastric malignant disease and to examine its value in the etiology. Infection with Helicobacter pylori is associated with an increased risk of gastric adenocarcinoma and gastric lymphoma. Materials and methods: We retrospectively examined the surgical specimens of 42 patients with malignant gastric tumors, who had been hospitalized in the second and fifth Department of General Surgery, Ministry of Health Ankara Training and Research Hospital, between 1998 and 2005 and treated with gastrectomy. Histological assessment and Helicobacter pylori density determinations were made according to Lauren and Sydney classifications, respectively. Results: Thirty-two had gastric carcinoma and 10 had gastric non-Hodgkin lymphoma. Helicobacter pylori infection was present in 10 (33.3%) of the gastric carcinoma patients and 7 (70%) of the gastric lymphoma patients. The density of Helicobacter pylori was ‘1' in nine gastric carcinoma and six gastric lymphoma cases, and ‘2' in one gastric carcinoma and one gastric lymphoma case. Helicobacter pylori prevalence is significantly higher in lymphoma cases than carcinoma cases. Diffuse type gastric carcinoma is more correlated with Helicobacter pylori than the intestinal type, and Helicobacter pylori density increases in conjunction with an increase in the gastric carcinoma clinical stage, but these findings were not significant. Conclusion: A high prevalence of Helicobacter pylori among the gastric lymphoma patients confirms the role of Helicobacter pylori in gastric lymphoma genesis.

Keywords:

Helicobacter pylori, gastric carcinoma, gastric lymphoma,

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