RAFET METE, Mustafa ORAN, Hayati GÜNEŞ, OĞUZHAN YILDIRIM, BİROL TOPÇU, MELTEM ÖZNUR, Tuncay KOÇ, İbrahim GELİNCİK

Tekirdağ bölgesinde Helicobacter pylori prevalansı ve patolojik parametrelerin çok yönlü analizi; literatür ile güncelleme

Amaç: Gerek yurt içi gerekse yurt dışı literatürlere bakıldığında Helicobacter pylori (H. pylori) ile Sydney sınıflamasındaki histolojik parametrelerin tümünü içine alan karşılaştırma nadirdir. Çalışmamızın amacı dispeptik şikayetler nedeniyle gastroskopi yapılmış ve antrum biyopsilerinde gastrit tanısı almış 797 hastadaki H. pylori sıklığını tespit etmek ve Sydney sınıflamasına göre yapılan histolojik parametreleri analiz edip H. pylori ile olan ilişkisini göstermektir. Gereç ve yöntem: Çalışmaya Mart 2010 ve Mart 2013 tarihleri arasında Namık Kemal Üniversitesi Tıp Fakültesi Gastroenteroloji Kliniği endoskopi ünitesinde gastroskopik incelenmesi yapılan ve patolojik olarak sadece gastritis tanısı alan 309'u erkek, 488'i kadın toplam 797 hasta alındı. Bulgular: Ortalama yaş 44.96 ±13.90 idi ve cinsler arasında yaş farklılığı yoktu (p>0.05). 700 (%87,7) hastada enflamasyon, 368 ( %46) hastada aktivasyon, 108 (%13,5) hastada intestinal metaplazi, 130 (%16.3) hastada atrofi ve 301 (%37.7) hastada lenfoid follikül mevcuttu. 587 (%73,7) hastada H. pylori pozitif idi. Sonuç: H. pylori prevalans oranımız %73,7 olup literatür ortalamasıyla ile benzerlik göstermektedir. İntestinal metaplazi sıklığımız literatür ortalamasının altındadır. Atrofi sıklığı literatüre göre anlamlı düşük idi. Toplam hastalardaki lenfoid follikül oranımız %37.7 ve H. pylori pozitif hastalardaki lenfoid follikül oranı ise %46,3 olup literatüre ile benzerdir

The prevalence of Helicobacter pylori in Tekirdag region and multi-faceted analysis of pathological parameters: Updated with the literature

Objective: Scanning both domestic and foreign literature, studies regarding correlation of Helicobacter pylori (H. pylori) with whole histologic parameters of Sydney classification are scarce. The aim of the present study was to to identify the frequency of H. pylori, to analyze the histological parameters according to Sydney classification, and to evaluate the correlation of H. pylori with these parameters in 797 patients whom endoscopy was done for dyspeptic complaints. Material and methods: The present study was conducted between March 2010 and March 2013 in the Gastroenterology Clinics of Namik Kemal University, Faculty of Medicine. 797 patients (309 male, 488 female, mean age: 44.96 ±13.90) who underwent gastroscopy and whose gastric mucosal biopsies revealed gastritis were included. Results: No difference in age and gender was observed (p>0,05). 700 (87,7 %) patients had inflammation, 368 ( 46 %) activation, 108 (13,5 %) intestinal metaplasia, 130 (16.3 %) atrophy, and 301 (37.7 %) lymhoid follicles. H. pylori was positive in 587 (73,7 %) patients. Conclusion: The prevalence of H. pylori was 73.7% and similar to the results of medical literature. Metaplasia and atrophy were lower than that of the previous studies. Lymphoid follicles were positive in 37.7% of the patients . In accordance with the previous data, 46.3% of H. pylori positive patients had lymphoid follicles and the results

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Marshall BJ, Warren JR. Unidentified curved bacilli in the sto- mach of patients with gastritis and peptic ulceration. Lancet 1984;1:1311-5.
Brooks GF, Butel JS, Morse SA. Jawetz Melnick and A delberg's Medical Microbiology. 21st ed. Connecticut: Appelet on and Lan- ge, 1998:543-65.
Graham DY, Malaty HM, Evans DG, et al. Epidemiology of He- licobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroente- rology 1991;100:1495-501.
Makola Di Peura DA, Crowe SE. Helicobacter pylori infection and related gastrointestinal diseases. J Clin Gastroenterol 2007; 41:548-58.
Dunn BE, Cohen H, Blaser MJ. Helicobacter pylori. Clin Microbi- ol Rev 1997;10:720-41.
Dixon MF, Genta R, Yardley JH, Correa P. Classification and gra- ding of gastritis. The updated Sydney System. International Work- shop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-8.
Wyatt JI. Histopathology of gastroduodenal inflamation: The im- pact of helicobacter pylori. Histopathology 1995;26:1-15.
Taylor DN, Blaser MJ. The epidemiology of Helicobacter pylori infections. Epidemiol Rev 1991;13:42-59.
İbiş M, Arhan M, Ödemiş B, ve ark. endoskopik olarak tanımlanan gastrit ile histolojik bulgular arasındaki ilişki. Akademik Gastro- enter Derg 2009;8:12-7.
Ozdil K, Sahin A, Kahraman R, ve ark. Current prevalence of in- testinal metaplasia and Helicobacter pylori infection in dyspeptic adult patients from Turkey. Hepatogastroenterology 2010;57:1563- 6.
Uyanıkoğlu A, Coşkun M, Binici DN, ve ark. Endoskopi yapılan hastalarda Helicobacter pylori sıklığı. Dicle Tıp Derg 2012;39:197- 200.
Özardalı Hİ, Bitiren M, Nazlıgül Y, Yılmaz N. Şanlıurfa yöresinde non erosiv gastritlerde Helicobacter pylori sıklığı. Genel Tıp Derg 1998;8:149-52.
Joos A, Nemzeth A, Zsolnay G, Kövari E, Papp J. Gastric biopsies and Helicobacter pylori. ORV Hetil 1995;136:1975.
Rugge M, Di Mario F, Cassaro M, et al. Pathology of the gastric antrum and body associated with Helicobacter pylori infection in non-ulcerous patients: is the bacterium a promoter of intestinal metaplasia? Histopathology 1993;22:9-15.
Khan A, Farooqui A, Raza Y, et al. Prevalence, diversity and dise- ase association of Helicobacter pylori in dyspeptic patients from Pakistan. J Infect Dev Ctries 2013;7:220-8.
Singh V, Trikha B, Nain CK, Singh K, Vaiphei K. Epidemiology of Helicobacter pylori and peptic ulcer in India. J Gastroenterol Hepatol 2002;17:659-65.
Ayoola AE, Ageely HM, Gadour MO, Pathak VP. Prevalence of Helicobacter pylori infection among patients with dyspepsia in South-Western Saudi Arabia. Saudi Med J 2004;25:1433-8.
Gunaid AA, Hassan NA, Murray-Lyon I. Prevalence and risk fa- ctors for Helicobacter pylori infection among Yemeni dyspeptic patients. Saudi Med J 2003;24:512-7.
Bani-Hani KE, Hammouri SM. Prevalence of Helicobacter py- lori in Northern Jordan. Endoscopy based study. Saudi Med J 2001;22:843-7.
Zaitoun AM. Histological study of chronic gastritis from the Uni- ted Arab Emirate susing the Sydney system of classification. J Clin Pathol 1994; 47: 810-5.
Britt DP, Barakat MH, Tungekar MF, et al. Helicobacter pylori in dyspeptic patients in Kuwait. J Clin Pathol 1990;43:987-91.
Hashemi MR, Rahnavardi M, Bikdeli B, Dehghani Zahedani M. H pylori infection among 1000 southern Iranian dyspeptic patients. World J Gastroenterol 2006;12:5479-82.
Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the gastric antrum. Gut 1992;33:16-20.
Kokkola A, Rautelin H, Puolakkainen P, et al. Diagnosis of Heli- cobacter pylori infection in patients with atrophic gastritis: com- parison of histology, 13C-urea breath test, and serology. Scand J Gastroenterol 2000;35:138-41.
Konakcı, Gülte M, İbanoğlu MS, ve ark. Kronik aktif gastritli ol- gularda Helicobacter pylori sıklığı. Uludağ Üniv Tıp Fakül Derg 2010:36 7-10.
Turkay C, Erbayrak M, Bavbek N, et al. Helicobacter pylori and histopathological findings in patients with dyspepsia. Turk J Gast- roenterol 2011;22:122-7.
Adım ŞB, Filiz G, Gürel S, Yerci Ö, Özgür T. Kronik gastrit olgu- larında intestinal metaplazi sıklığı ve intestinal metaplazi ile Heli- cobacter pylori ilişkisi. Uludağ Üniv Tıp Fakül Derg 2008;34:1-4.
Taşkın V, Gürer İ, Sarı R, et al. The prevalence of lymphoid follic- les and intestinal metaplasia in Helicobacter pylori associated cli- nically significant gastroduodenal diseases. Turk J Gastroenterol 1999;10:197-201.
Stolte M, Eidt S. Lymphoid follicles in antral mucosa: Immun respons eto Campylobacter pylori. J Clin Pathol 1989;42:1269-71.
Zaitoun AM. The prevalance of lymphoid follicles in Helicobac- ter pylori associated gastritis in patients with ulcers and non-ulcer dyspepsia. J Clin Pathol 1995;48:325-9.
Wyatt JL, Dixon MF. Chronic gastritis a pathogenetic aproach. J Pathol 1988;154:113-24.