Dispeptik yakınmalar ile başvuran hastalarda mide kanseri öncü lezyonlarının görülme sıklığı

Amaç: Türkiye’nin güneydoğusundaki illerde Helicobacter pylori enfeksiyonu ve mide kanseri oldukça sık görülmektedir. Bu çalışma ile Adıyaman Devlet Hastanesinde dispeptik yakınmalar sebebiyle başvuran hastalarda mide kanseri öncü lezyonlarının görülme sıklığını değerlendirmek amaçlanmıştır. Gereç ve yöntem: Ocak 2009 ile Mayıs 2009 tarihleri arasında dispeptik yakınmalar nedeni ile başvuran ardışık 234 hasta çalışmaya alınmıştır. Yapılan üst gastrointestinal sistem endoskopisi sırasında mide antrum ve korpusdan biyopsiler alınarak, histopatolojik inceleme (Sydney sınıfaması) ile kronik gastrit, gastrik atrof, intestinal metaplazi ve displazi tanıları konulmuştur. Bulgular: İncelenen hastaların yaş ortalaması 46±15 (16-82) yıl idi. Alınan biyopsi örneklerinden, hastaların %66.7’sinde Helicobacter pylori enfeksiyonu teşhis edildi. Histopatolojik incelemede; normal mukoza %2.7, kronik gastrit %78.6, gastrik atrof %3.4, intestinal metaplazi %11.5 ve displazi %3.8 oranlarında görüldü. Helicobacter pylori enfeksiyonu olan hastalarda intestinal metaplazi görülme sıklığı Helicobacter pylori enfeksiyonu olmayan hastalara göre anlamlı oranlarda yüksekti (sırasıyla, %9.8 ile %1.7, p=0.021). Gastrik atrof sıklığı (sırasıyla %3.0 ile %0.4 p=0.19) ve displazi sıklığı (sırasıyla, %3.0 ile %0.8 p=0.37) ise Helicobacter pylori enfeksiyonu olan hastalarda olmayanlardan daha yüksek olmakla beraber aradaki fark istatistiksel anlamlı düzeye ulaşmamaktaydı (p>0.05). Sonuç: Mide kanseri öncü lezyonları olan gastrik atrof, intestinal metaplazi, displazi ile Helicobacter pylori enfeksiyonu dispeptik yakınmalar ile başvuran hastalarda sıklıkla görülmektedir. Bu durum Türkiye’nin güneydoğusunda yüksek insidansda görülen mide kanseri ile ilgili olabilir.

Prevalence of gastric cancer precursor lesions in patients with dyspepsia

Objectives: In Southeastern cities of Turkey, high prevalences of Helicobacter pylori infection and gastric cancer are seen. The aim of this study was to evaluate the frequency of the precancerous gastric lesions in patients with dyspeptic symptoms who underwent upper gastrointestinal endoscopy in Adıyaman State Hospital. Materials and methods: We analyzed gastric biopsies taken from corpus and antrum of 234 consecutive patients who underwent upper gastrointestinal endoscopy between January 2009 and May 2009. According to Sydney system, chronic gastritis, gastric atrophy, intestinal metaplasia and dysplasia were diagnosed by histological examination. Results: The mean age of patients was 46±15 (16- 82) years. Helicobacter pylori infection was seen in 66.7% of patients. Normal mucosa, chronic gastritis, gastric atrophy, intestinal metaplasia and dysplasia were diagnosed in 2.7%, 78.6%, 3.4%, 11.5% and 3.8% of gastric biopsy specimens, respectively. Helicobacter pylori infected patients showed a signifcantly higher prevalence of intestinal metaplasia compared with that of the non infected subjects (9.8% vs 1.7% p=0.021). Although prevalence of gastric atrophy and dysplasia were higher among Helicobacter pylori infected patients, the difference did not reached to a statistically signifcant level (3.0% vs 0.4% p=0.19 and 3.0% vs 0.8% p=0.37 respectively). Conclusion: Our fndings suggested that the prevalence of gastric precancerous lesions such as gastric atrophy, intestinal metaplasia, dysplasia and Helicobacter pylori infection were high in dyspeptic patients. This may be related to actual high incidence of gastric cancer in southeastern region of Turkey.

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