Cerrahi ünitemizde yapılan kolonoskopik polipektomilerin histopatolojik sonuçları

Giriş ve Amaç: Kolorektal kanserlerin %95’inden fazlası adenomatöz polipten orijin alır. Kanserlerin büyük bir çoğunluğu normal görünümlü mukozadan adenomaya, displaziye ve nihai olarak karsinoma geçiş göstmektedir. Biz bu çalışmada cerrahi ünitemizde yapılan kolonoskopik polipektomilerin histopatolojik özelliklerini irdelemeyi amaçladık. Gereç ve Yöntem: Erzurum Bölge Eğitim ve Araştırma Hastanesi Cerrahi Endoskopi ünitesinde Ocak-2013 ile Aralık-2015 yılları arasında kolonoskopik polipektomi yapılan hastaların verileri bölümümüz bilgi işlem veritabanından retrospektif olarak tarandı. Bulgular: Hastalarımızda polip görülme oranı %16,1 idi. Hastaların 165’i (%63,5) erkek, 95’i (36,5) kadın idi. Yaş ortalaması 60,87±13,1 (24-93) idi. Lokalizasyona göre polipler %42,1’i sigmoid kolon ve %29,6’sı rektumda idi. Histopatolojik değerlendirmede, poliplerin %49,5’i neoplastik polip idi. Bu poliplerin %40,2’si tübüler adenom, %4,4’ü tübülovillöz adenom, %0,6’sı villöz adenom, %1,2’si intramukozal karsinom, %3,1’i adenokarsinom idi. Adenomatöz poliplerin 52’sinde (%33) displazi izlendi. Bunların 48’i (%92) düşük dereceli displazi, 4’ü (%3) yüksek dereceli displazi idi. Polip çapı ile displazi arasında pozitif korelasyon izlendi (p=0,038). Yüksek dereceli displazi görülen hastaların tümü 50 yaş üstü hastalardı. Fakat genç hastalarda total displazi oranı daha yüksekti ve istatistiksel olarak anlamlı idi (P=0,005). Sonuç: Biz bu çalışmada kanser öncüsü olan adenomatöz poliplerde, literatür ile uyumlu olarak polip çapının displazi ile pozitif korelasyon gösterdiğini, total displazinin genç hastalarda, yüksek dereceli displazinin de yaşlı hastalarda daha yüksek olduğunu tespit ettik.

Anahtar Kelimeler:

Polip, adenom, displazi

Histopathological results of colonoscopic polypectomy in a surgery unit

Background and Aims: More than 95% of colorectal cancers are of adenomatous polyps origin. A large majority of cancers undergo a transition from normal-looking mucosa to adenoma, dysplasia, and eventually carcinoma. In this study, we aimed to investigate the histopathologic features of colonoscopic polypectomy performed in our surgical unit. Materials and Methods: The data from patients who underwent colonoscopic polypectomy between January 2013 and December 2015 in the surgical endoscopy unit at Erzurum Regional Training and Research Hospital were scanned retrospectively from our department data processing database. Results: The rate of polyps in our patients was 16.1%. One hundred and sixty-five (63.5%) of the patients were male, and 95 (36.5%) were female. The mean age was 60.87±13.1 years (24-93 years old). According to polyp location, 42.1% were in the sigmoid colon, and 29.6% were in the rectum. On histopathological evaluation, 49.5% of the polyps were neoplastic polyps. Tubular adenomas were found in 40.2%, tubulovillous adenomas in 4.4%, villous adenomas in 0.6%, intramucosal carcinomas in 1.2%, and adenocarcinomas in 3.1% of these polyps. Dysplasia was observed in 52 (33%) of adenomatous polyps. Of these, 48 (92%) were low-grade dysplasia, and 4 (3%) were high-grade dysplasia. A positive correlation was observed between polyp diameter and dysplasia (p=0.038). All of the patients with high-grade dysplasia were over 50 years old. However, the rate of total dysplasia was higher in younger patients and was statistically significant (p=0.005). Conclusion: In this study, we found that polyp diameter correlates positively with dysplasia in adenomatous polyps, which are cancer precursors, and that total dysplasia is higher in young patients and high-grade dysplasia in elderly patients.

Keywords:

Polyp, adenoma, dysplasia,

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