Öz
Giriş ve Amaç: Kolorektal premalign lezyonların en önemlisi poliplerdir. Poliplerin histopatolojisi ve boyutlarına göre malignite riski değişmektedir. Ayrıca mide mukozasında displazi, atrofi, intestinal metaplazi, polip ve Helicobacter pylori gibi faktörler de mide için prekanseröz durumlardır. Çalışmamızın amacı; kolorektal poliplerin yerleşimi, boyutu, sayısı ve patolojisi ile midenin premalign lezyonları arasındaki ilişkiyi ortaya koymaktır.
Gereç ve Yöntem: Çalışmamız Ekim 2016 ile Ekim 2019 tarihleri arasında 18 yaş ve üzeri hastalara aynı gün yapılan özofagogastroduodenoskopi ve kolonoskopi verilerinin değerlendirildiği retrospektif bir çalışmadır. İnflamatuvar barsak hastalığı olan, mide kanseri ve kolorektal kanser tanısı alan, mide biyopsisi alınmayan, barsak temizliği yetersiz olan ve işlemi tamamlayamayan hastalar çalışmaya dahil edilmemiştir.
Bulgular: İki yüz elli yedi hastanın %58.0’i erkek ve %80.9’u 50 yaşın üzerindeydi. Kolorektal poliplerin çoğunluğu distal yerleşimliydi (%59.1). İleri adenomatöz polip (İAP) sıklığı %24.9 olup ileri adenomatöz polip varlığı ile 50 yaş altı ve üzeri hastalar arasında ve cinsiyete göre istatistiksel fark yoktu (p: 0.659 ve p: 0.747). Helicobacter pylori, atrofi, intestinal metaplazi, displazi ve polip gibi midenin premalign lezyonları ile ileri adenomatöz polip arasında istatistiksel olarak anlamlı bir ilişki gözlenmedi (p: 0.301 ).
Sonuç: Kolorektal poliplerin yeri, sayısı ve ileri adenomatöz polip ile premalign mide lezyonları arasında ilişki saptanmamıştır.
Anahtar Kelimeler
Kaynakça
- 1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90.
- 2. Rex DK, Boland CR, Dominitz JA, et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2017;153:307-23.
- 3. Frank SA. Dynamics of Cancer: Incidence, Inheritance, and Evolution. Princeton (NJ): Princeton University Press; 2007. Chapter 3, Multistage Progression. Available from: http://www.ncbi.nlm.nih.gov/books/ NBK1562
- 4. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 1993;329:1977-81.
- 5. Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012;366:687-96.
- 6. Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36:2251-70.
- 7. Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy. Gastroenterology 2012;143:844-57.
- 8. Dinis-Ribeiro M, Lopes C, da Costa-Pereira A, Moreira-Dias L. We would welcome guidelines for surveillance of patients with gastric atrophic chronic and intestinal metaplasia! Helicobacter 2008;131:75-6.
- 9. WHO Classification of Digestive System Tumors 5. Ed. 2019 WHO Classification of Tumor Editorial Board (Fatima Carniero et al.) IARC, Lyon, France. Chapter Tumors of the Stomach Fukayama M, Rugge M, Washington MK. Page: 59-110
- 10. Unler GK, Gokturk HS, Toprak E, Erinanc OH, Korkmaz H. Does the presence of endometrial polyp predict colorectal polyp? Am J Med Sci 2016;351:129-32.
- 11. Kawahara Y, Kodama M, Mizukami K, et al. Endoscopic gastric mucosal atrophy as a predictor of colorectal polyps: a large scale case-control study. J Clin Biochem Nutr 2019;65:153-9.
- 12. Brim H, Zahaf M, Laiyemo AO, et al. Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans. BMC Cancer 2014;14:296.
- 13. Zhang S, Zheng D, Yang Z, et al. Patients with gastric polyps need colonoscopy screening at younger age: A large prospective cross-sectional study in China. J Cancer 2019;10:4623-32.
- 14. Yang W, Yang X. Association between Helicobacter pylori infection and colorectal adenomatous polyps. Gastroenterol Res Pract 2019;2019:7480620.
- 15. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-81.
- 16. Sonnenberg A, Genta RM. Helicobacter pylori is a risk factor for colonic neoplasms. Am J Gastroenterol 2013;108:208-15.
- 17. O'brien MJ, Winawer SJ, Zauber AG, et al. Flat adenomas in the National Polyp Study: is there increased risk for high-grade dysplasia initially or during surveillance? Clin Gastroenterol Hepatol 2004;2:905-11.
- 18. Regula J, Rupinski M, Kraszewska E, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006;355:1863-72.
Öz
Background and Aims: Polyps are the most important premalignant colorectal lesions. The risk for malignancy with polyps differs with its histopathology and size. Moreover, factors in the gastric mucosa such as dysplasia, atrophy, intestinal metaplasia, polyp, and Helicobacter pylori are precancerous conditions for the stomach. In this study, we studied the relationship between the location, size, number, and pathology of colorectal polyps and premalignant gastric lesions. Material and Methods: This was a retrospective study that analyzed the data of patients of age ≥18 years who underwent esophagogastroduodenoscopy and colonoscopy on the same day between October 2016 and October 2019. Patients with a history of an inflammatory bowel disease, diagnosis of gastric cancer and colorectal cancer, those who did not undergo gastric biopsy, and those in whom sufficient colonic irrigation was not performed and who could not complete the procedure were excluded from the study. Results: Of the 257 patients, 58% were men and 80.9% were >50 years of age. The location of the majority of colorectal polyps was distal (59.1%). The incidence of Advanced Adenomatous Polyp was 24.9%, with no statistical difference in the presence of Advanced Adenomatous Polyp between the ages younger and older than 50 years according to their gender (p=0.659 and p=0.747). No statistically significant relationship was observed between Advanced Adenomatous Polyp and premalignant gastric lesions, such as Helicobacter pylori, atrophy, intestinal metaplasia, dysplasia, and polyp (p=0.301). Conclusions: No relationship was observed among the location, number, and Advanced Adenomatous Polyp rate of colorectal polyps and premalignant gastric lesions.
Keywords: , , ,
Anahtar Kelimeler
Kaynakça
- 1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90.
- 2. Rex DK, Boland CR, Dominitz JA, et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2017;153:307-23.
- 3. Frank SA. Dynamics of Cancer: Incidence, Inheritance, and Evolution. Princeton (NJ): Princeton University Press; 2007. Chapter 3, Multistage Progression. Available from: http://www.ncbi.nlm.nih.gov/books/ NBK1562
- 4. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 1993;329:1977-81.
- 5. Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012;366:687-96.
- 6. Muto T, Bussey HJR, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36:2251-70.
- 7. Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy. Gastroenterology 2012;143:844-57.
- 8. Dinis-Ribeiro M, Lopes C, da Costa-Pereira A, Moreira-Dias L. We would welcome guidelines for surveillance of patients with gastric atrophic chronic and intestinal metaplasia! Helicobacter 2008;131:75-6.
- 9. WHO Classification of Digestive System Tumors 5. Ed. 2019 WHO Classification of Tumor Editorial Board (Fatima Carniero et al.) IARC, Lyon, France. Chapter Tumors of the Stomach Fukayama M, Rugge M, Washington MK. Page: 59-110
- 10. Unler GK, Gokturk HS, Toprak E, Erinanc OH, Korkmaz H. Does the presence of endometrial polyp predict colorectal polyp? Am J Med Sci 2016;351:129-32.
- 11. Kawahara Y, Kodama M, Mizukami K, et al. Endoscopic gastric mucosal atrophy as a predictor of colorectal polyps: a large scale case-control study. J Clin Biochem Nutr 2019;65:153-9.
- 12. Brim H, Zahaf M, Laiyemo AO, et al. Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans. BMC Cancer 2014;14:296.
- 13. Zhang S, Zheng D, Yang Z, et al. Patients with gastric polyps need colonoscopy screening at younger age: A large prospective cross-sectional study in China. J Cancer 2019;10:4623-32.
- 14. Yang W, Yang X. Association between Helicobacter pylori infection and colorectal adenomatous polyps. Gastroenterol Res Pract 2019;2019:7480620.
- 15. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-81.
- 16. Sonnenberg A, Genta RM. Helicobacter pylori is a risk factor for colonic neoplasms. Am J Gastroenterol 2013;108:208-15.
- 17. O'brien MJ, Winawer SJ, Zauber AG, et al. Flat adenomas in the National Polyp Study: is there increased risk for high-grade dysplasia initially or during surveillance? Clin Gastroenterol Hepatol 2004;2:905-11.
- 18. Regula J, Rupinski M, Kraszewska E, et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006;355:1863-72.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 28 Sayı: 2 |
