Evrim KAHRAMANOĞLU AKSOY, Muhammet Yener AKPINAR, Ferdane PİRİNÇCİ SAPMAZ, ZEYNEP GÖKTAŞ, Gülçin Güler ŞİMŞEK, Metin UZMAN, Yaşar NAZLIGÜL

Prekanseröz lezyonların Helicobacter pylori eradikasyonuna olan etkisi

Giriş ve Amaç: Mide mukozasındaki Helicobacter pylori yoğunluğu, inflamasyonun aktivite derecesi, gastrit şiddeti ile eradikayon başarısı arasındaki ilişkiyi gösteren çalışma sayısı sınırlıdır. Biz çalışmamamızda; Helicobacter pylori eradikasyon başarısı üzerine gastrit şiddetinin ve Sidney klasifikasyon parametrelerinin etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya; Temmuz 2017 ve Aralık 2017 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi’nde Helicobacter pylori enfeksiyonu patoloji olarak konmuş, eradikasyon için bizmut içeren standart dörtlü tedaviyi tamamlayan hastalar dahil edildi. Bulgular: Çalışmaya toplam 634 hasta dahil edildi. Antrumda atrofi varlığında Helicobacter pylori eradikasyon başarısı düşükken, intestinal metaplazi varlığında eradikasyon başarısı etkilenmemiştir (sırasıyla p=0,025 ve p >0,05); benzer şekilde korpustaki atrofi ve intestinal metaplazi olan grupta da eradikasyon başarısı daha azdı (sırasıyla p=0,016 ve p=0,01). Şiddetli gastrit gruplarında eradikasyon başarısızlığı daha fazlaydı (OLGA III-IV için p=0.015, OLGIM III-IV için p=0.032). Multiple lineer regresyon analizinde değerlendirildiğinde korpus intestinal metaplazi ve lenfoid agregasyon şiddeti bağımsız risk faktörü olarak değerlendirilmiştir (sırasıyla p=0.002 ve p=0.042). Sonuç: Gastrit ciddiyeti, intestinal metaplazi ve gastrik atrofi Helicobacter pylori eradikasyon tedavisi başarısı üzerinde negatif etki göstermektedir. Bu yüzden, patolojilerinde bu özelliklere sahip olan hastalarda tedavi protokolü ve tedavi süresi yeniden gözden geçirilmelidir.

Anahtar Kelimeler:

Atrofi, Helicobacter pylori, intestinal metaplazi

Precancerous lesions effects on the eradication of Helicobacter pylori

Background and Aims: There is limited data regarding the effect of gastritis severity, the existence of atrophy, and intestinal metaplasia on the Helicobacter pylori eradication. Herein we aimed to investigate the relationship between Helicobacter pylori eradication and histopathological parameters like gastritis severity, intestinal metaplasia and/or atrophy, and the Sydney classification. Material and Methods: Patients diagnosed with Helicobacter pylori gastritis were enrolled in the study between July 2017 and December 2017. All patients received standard quadruple therapy with bismuth salt. Results: In total, 634 patients were enrolled. The success of Helicobacter pylori eradication in the presence of atrophy in the gastric antrum was low, while the eradication success was not affected in the presence of intestinal metaplasia (p=0.025 and p >0.05, respectively). Eradication success was lower in the group with atrophy and intestinal metaplasia in the antrum (p=0.016 and p=0.01, respectively). Eradication failure was higher in the group with severe gastritis (p=0.015 for OLGA III-IV, p=0.032 for OLGIM III-IV). Intestinal metaplasia in the corpus and severity of the lymphoid aggregation were independent risk factors for treatment failure (p=0.002 and p=0.042, respectively). Conclusion: Severity of gastritis, intestinal metaplasia, and gastric atrophy had a negative effect on Helicobacter pylori eradication success. Treatment protocols and duration should be carefully planned in patients with these features.

Keywords:

Atrophy, Helicobacter pylori, intestinal metaplasia,

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