Helicobacter pylori gastriti için tanımlanan etat mamillone görünümünün histopatolojik bulgular ile korelasyonu

Giriş ve Amaç: Etat mamillone endoskopik olarak gözlenen ve Helicobacter pylori pozitif olan hastalarda mukozal nodüler tutulum ile karakterize kolaylıkla tanınabilen karakteristik bir bulgudur. Biz bu çalışmada etat mamillone görüntüsü nedeniyle endoskopik biyopsi alınan hastalarda bu görüntünün histopatolojik tanıya göre doğruluğunu araştırdık. Gereç ve Yöntem: Bu çalışma Ocak 2016-Aralık 2017 tarihleri arasında hastanemiz gastroenteroloji kliniğinde çeşitli sebeplerle endoskopi yapılan hastaların hasta kayıtları incelenerek retrospektif olarak yapılmıştır. Toplamda 5200 endoskopi kaydı incelenmiş, etat mamillion veya etat mamillone tabiri geçen 53 hasta çalışmaya dahil edilmiştir. Bulgular: Araştırma popülasyonu 41 kadın (%77) ve 12 erkek (%23)  erkek hasta olmak üzere 53 kişiden oluştu. Hastaların ortalama yaşı 29±11.2 (18-56) yıldı. Hastaların endoskopik biyopsi sonuçlarına bakıldığında 4 (%8) hastada atrofik gastrit mevcut iken 49 (%92) hastada atrofi yoktu. Hastaların biyopsi örnekleri incelendiğinde 53 hastanın 45’inde Helicobacter pylori pozitif saptandığı görüldü (%85). Bu hastaların Sydney sınıflamasına göre 12’sinde 1+ Helicobacter pylori (%23), 17’sinde 2+ Helicobacter pylori (%32)  ve 16’sında 3+ Helicobacter pylori (%30)  saptanmıştır. Endoskopik etat mamillone görüntüsü ile biyopsi sonuçları arasında %85 oranında korelasyon olduğu görülmüştür. Sonuç: Endoskopik olarak tanımlanan etat mamillone görünümü Helicobacter pylori gastriti tanısı için kullanılabilecek non-invaziv ve yüksek doğruluk oranına sahip bir yöntemdir.

Correlation of etat mamillone appearance with histopathological findings for Helicobacter pylori gastritis

Background and Aims: Etat mamillone is an endoscopic appearance characterized by mucosal nodular involvement in patients with Helicobacter pylori gastritis. In the present study, we investigated the accuracy of this appearance on the basis of histopathological diagnosis in patients who underwent endoscopic biopsy for etat mamillone. Material and Methods: The present study was performed retrospectively between January 2016 and December 2017 in the gastroenterology clinic of our hospital. A total of 5200 endoscopy records were examined, and 53 patients with etat mamillion or etat mamillone were included in the study. Results: The study population consisted of 53 patients, 41 of whom were female (77%) and 12 male (23%). The mean age of the patients was 29±11.2 years (range: 18–56 years). Atrophic gastritis was observed in four patients (8%), while 49 patients (92%) had no atrophy. Upon biopsy, 45 of the 53 patients (85%) were found to be Helicobacter pylori positive. According to the Sydney classification, 12 patients had 1+ Helicobacter pylori (23%), 17 had 2+ Helicobacter pylori (32%), and 16 had 3+ Helicobacter pylori (30%). There was 85% correlation between the endoscopic etat mamillone appearance and biopsy results. Conclusion: Endoscopic etat mamillone appearance is a non-invasive and highly accurate method for diagnosis of Helicobacter pylori gastritis.

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  • 1-Ceylan A, Kirimi E, Tuncer O, Türkdoğan K, Ariyuca S, Ceylan N. Prevalence of Helicobacter pylori in children and their family members in a district in Turkey. J Health Popul Nutr 2007;25:422-7. 2- Iannone A, Giorgio F, Russo F, et al. New fecal test for non-invasive Helicobacter pylori detection: A diagnostic accuracy study. World J Gastroenterol 2018;24:3021-9. 3-Hooi JKY, Lai WY, Ng WK, et al. Global Prevalence of Helicobacter pylori infection: Systematic review and meta-analysis. Gastroenterology 2017;153:420-9. 4-Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1984;323:1311-5. 5- Seo JH, Park JS, Rhee KH, Youn HS. Diagnosis of Helicobacter pylori infection in children and adolescents in Korea. Pediatr Gastroenterol Hepatol Nutr 2018;21:219-33. 6- Lopes AI, Vale FF, Oleastro M. Helicobacter pylori infection - recent developments in diagnosis. World J Gastroenterol 2014;20:9299-313. 7- Kato T, Yagi N, Kamada T, et al; Study Group for Establishing Endoscopic Diagnosis of Chronic Gastritis. Diagnosis of Helicobacter pylori infection in gastric mucosa by endoscopic features: a multicenter prospective study. Dig Endosc 2013;25:508-18. 8- İbiş M, Arhan M, Ödemiş B, et al. Endoskopik olarak tanımlanan gastrit ile histolojik bulgular arasındaki ilişki. Akademik Gastroenteroloji Dergisi 2009;8:12-7. 9- Ona FV, Damevski K. Gastroscopic diagnosis of état mamelonné. Gastrointest Endosc 1977;23:209-10. 10- Stolte M, Meining A. The updated Sydney system: classification and grading of gastritisas the basis of diagnosis and treatment. Can J Gastroenterol 2001;15:591-8. 11-Sabbagh P, Mohammadnia-Afrouzi M, Javanian M, et al. Diagnostic methods for Helicobacter pylori infection: ideals, options, and limitations. Eur J Clin Microbiol Infect Dis 2019;38:55-66. 12-Skrebinska S, Mégraud F, Bessède E. Diagnosis of Helicobacter pylori infection. Helicobacter 2018;23(Suppl 1):e12515. 13- Bah A, Saraga E, Armstrong D, et al. Endoscopic features of Helicobacter pylori-related gastritis. Endoscopy 1995;27:593-6. 14- Calabrese C, Di Febo G, Brandi G, et al. Correlation between endoscopic features of gastric antrum, histology and Helicobacter pylori infection in adults. Ital J Gastroenterol Hepatol 1999;31:359-65. 15- Kotilea K, Kalach N, Homan M, Bontems P. Helicobacter pylori infection in pediatric patients: Update on diagnosis and eradication strategies. Paediatr Drugs 2018;20:337-51. 16- Khakoo SI, Lobo AJ, Shepherd NA, Wilkinson SP. Histological assessment of the Sydney classification of endoscopic gastritis. Gut 1994;35:1172-5. 17- Redeen S, Petersson F, Jonsson KA, Borch K. Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample. Endoscopy 2003;35:946-50. 18- Mihara M, Haruma K, Kamada T, et al. The role of endoscopic findings for the diagnosis of Helicobacter pylori infection: evaluation in a country with high prevalence of atrophic gastritis. Helicobacter 1999;4:40-8.