ENVER YARIKKAYA, Senay ERDOGAN-DURMUS, Rabia DEMIRTAS

KOLOREKTAL POLİPLERİN KLİNİKOPATOLOJİK ÖZELLİKLERİ: TÜRKİYE'NİN KUZEY-DOĞU ANADOLU BÖLGESİNDEN RETROSPEKTİF BİR ÇALIŞMA

Amaç: Bu çalışmanın amacı kolon poliplerinin lokalizasyon, prezentasyon ve histopatolojik özelliklerini incelemektir.Gereç ve Yöntemler: 2014-2016 yılları arasında Ağrı Devlet Hastanesi ve Erzurum Bölge Eğitim ve Araştırma Hastanesi'nde kolon polibi nedeni ile kolonoskopi yapılan 123 hastanın 153 biyopsi örneğini retrospektif olarak inceledik.Bulgular: Ortalama yaş 58.9 ± 15.6 yıldı (Dağılım: 19-90 yıl). Hastaların 78'i (% 63,4) erkek, 45'i (% 36,6) kadındı. 25 (% 20.3) hastada iki veya üç (çoklu) polip vardı. 4 biyopsi örneğinde (% 2.6) tübüler adenomadan karsinom tanısı kondu. En yaygın polip türü adenomatöz polip (n: 123,% 80.3) idi. Poliplerin en sık anatomik lokasyonları 45 (% 29.4) olguda rektum, 45 (% 29.4) olguda sigmoid kolon idi. Poliplerin ortalama büyüklüğü 4,1 mm (aralık: 1 mm-20 mm) idi. Yüksek dereceli displazi, 123 (% 13.2) adenomatöz polipten 20'sinde saptandı. Yüksek dereceli displazi ve düşük dereceli displazili adenomatöz poliplerde ortalama çaplar anlamlı olarak farklıydı (p <0.05). Sonuç: Poliplerin çoğu 50 yaş ve üzerindeki hastalarda tanımlandı. Poliplerin % 50'sinden fazlası kolonun rektosigmoid bölümünde bulundu. Poliplerin çoğunluğu adenomatöz idi ve geniş çaplı poliplerde yüksek dereceli displazi saptandı.

Anahtar Kelimeler:

adenoma, displazi, adenomatöz polipler

CLINICOPATHOLOGIC FEATURES OF COLORECTAL POLYPS: A RETROSPECTIVE STUDY FROM NORTH-EASTERN ANATOLIA REGION OF TURKEY

Objectives: The aim of this study is to examine the patient characteristics, locations, presentations and histopathological features of colon polyps.Material and methods: We analyzed 153 biopsy specimens of 123 patients who underwent colonoscopy with biopsy of colonic polyps during a two-year period from 2014 to 2016, in Ağrı State Hospital and Erzurum Regional Training and Research Hospital, retrospectively. Results: The mean age was 58.9±15.6 years (Range: 19-90 years). 78 (63.4%) patients were males and 45 (36.6%) patients were females. 25 (20.3%) patients had two or three (multiple) polyps. In 4 biopsy specimens (2.6%) were diagnosed with carcinoma arose from tubular adenomas. The most common type of polyp was the adenomatous polyp (n:123, 80.3%). The most common anatomical locations of polyps were the rectum in 45 (29.4%) cases and the sigmoid colon in 45 (29.4%) cases. The mean size of polyps was 4.1 mm (range: 1mm-20 mm). High-grade dysplasia was found in 20 of 123 (13.2%) adenomatous polyps. Mean diameters were significantly different in adenomatous polyps with high-grade dysplasia and low-grade dysplasia (p<0.05). Conclusion: Most of the polyps were identified in patients aged 50 years or older. More than 50% of the polyps were found in the rectosigmoid part of the colon. The majority of the polyps were adenomatous and high-grade dysplasia was detected in large diameter polyps.

Keywords:

dysplasia, adenoma, adenomatous polyps,

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1. Albasri A, Yosef H,Hussainy A, et al. Profile of colorectal polyps: a retrospective study from King Fahad Hospital, Madinah, Saudi Arabia. Asian Pac J Cancer Prev. 2014; 15 (6): 2669-2673.

2. Mirzaie AZ, Abolhasani M, Aryamanesh A. Left sided colorectal adenomatous polyps have more risk for high grade dysplasia. ActaMedicaIranica. 2013; 51(3): 172-177.

3. Kalimuthu SN, Chelliah A, Chetty R. Fromtraditionalserrated adenoma totubulovillous adenoma andbeyond. World J GastrointestOncol. 2016; 8(12): 805–809.

4. Shussman N, Wexner SD. Colorectal polyps and polyposis syndromes. Gastroenterol Rep (Oxf). 2014;2(1):1-15.

5. Gibson JA, Odze RD. Pathology of premalignant colorectal neoplasia. Digestive Endoscopy. 2016; 28: 312–323.

6. Hornick JL, Odze RD. Polyps of large intestine. In: Odze RD, Hornick JL (eds). Odze and Goldblum surgical pathology of the GI tract, liver, biliary tract, and pancreas. 3rd edition. China: Saunders-Elsevier; 2015, 607-657.

7. Iacobuzio-Donahue CA. Epithelial neoplasms of the colorectum. In: Iacobuzio-Donahue CA, Montgomery E. (eds). Gastrointestinal and Liver Pathology. 2nd edition. China: Saunders-Elsevier; 2012, 410-441.

8. Nouraie M, Hosseinkhah F, Zamanifekri B, et al. Clinicopathological features colon polyps from African- Americans. Dig Dis Sci. 2010; 55(5): 1442–1449.

9. Vyas M, Yang X, Zhang X. Gastric hamartomatous polyps—Review and update. Clin Med Insights Gastroenterol. 2016; 9: 3–10.

10. Qureshi A, Shihi SA, Ali Z. A retrospective study of clinico-pathological characteristics of colonic polyps in adults seen at a tertiary care centre. J Pak Med Assoc. 2017; 67: 12-14.

11. Qumseya BJ, Coe S, Wallace MB. The effect of polyp location and patient gender on the presence of dysplasia in colonic polyps. ClinTranslGastroenterol. 2012; 3(7): e20.

12. Munteanu M, Serban C, Savoiu G, Popescu A, Sporea I. Clinical, endoscopic and morphological study of colorectal polyps. Ann RSCB. 2009; 14, 1-4.

13. Zahir ST, Binesh F, Hashemian Z, Hakimi A. Demographic survey on colorectal polyps in ShahidSadoughi Hospital, Yazd, Iran. Rawal Medical Journal. 2010; 35, 31-3.

14. Wisedopas N, Thirabanjasak D, Taweevisit M. A retrospective study of colonic polyps in King Chulalongkorn Memorial Hospital. J Med Assoc Thai. 2005; 88, 36-41.

15. Bafandeh Y, Daghestani D, Esmaili H. Demographic and anatomical survey of colorectal polyps in an Iranian population. Asian Pac J Cancer Prev. 2005; 6, 537-40.

16. Lam TJ, Wong BC, Mulder CJ, et al. Increasing prevalence of advanced colonic polyps in young patients undergoing colonoscopy in a referral academic hospital in Hong Kong. World J Gastroenterol. 2007 13, 3873-7.

17. Al-Enezi SA, Alsurayei SA, Ismail AE. Adenomatouscolorectalpolyps in patientsreferredforcolonoscopy in a regionalhospital in Kuwait. Saudi J Gastroenterol. 2010; 16: 188-93.

18. Al-Rashed RS, Al-Amri SM. Colonicpolyps: ExperiencefromKingKhalidUniversityHospital. AnnSaudiMed. 1996; 16: 180-3.

19. Zare-Mirzaie A, Abolhasani M, Aryamanesh A. Left Sided Colorectal Adenomatous Polyps Have More Risk for High Grade Dysplasia. Acta Med Iran. 2013; 51:172-7.

20. Valarini SBM, Bortoli VT, Wassano NS, et al. Correlation between location, size and histologic type of colorectal polyps at the presence of dysplasia and adenocarcinoma. J. Coloproctol. 2011; 31:3.