Gastrik Intestinal Metaplazi Sıklığı ve Helikobakter Pilori ile İlişkisinin Belirlenmesi

Year 2022, Volume: 4 Issue: 3, 467 - 472, 22.09.2022

Serdar Durak , Arif Mansur Coşar , Sami Fidan

https://doi.org/10.37990/medr.1158426

Cited By: 1

Abstract

Amaç: Gastrik intestinal metaplazi (IM) mide kanserine giden yolda prekanseröz bir lezyondır. Helikobakter pilori (HP) non-kardia mide kanseri gelişiminde artış ile ilişkilendirilen, gastrik IM ile atrofik gastrit gelişiminde rol alan bir bakteridir. Bu çalışma ile dispepsi endikasyonu ile endoskopik inceleme yapılan hastalarda IM sıklığını ve HP ile ilişkisini belirlemeyi amaçladık.
Materyal ve Metot: Çalışmada Ocak 2019-Ocak 2020 tarihleri arasında dispepsi nedeni ile Karadeniz Teknik Üniversitesi Farabi Hastanesi Gastroenteroloji Kliniği’nde üst gastrointestinal sistem endoskopisi yapılıp mide biyopsisi alınan 2530 hastanın yaş ve cinsiyet gibi demografik özellikleri ile biyopsi bulguları (IM, HP, atrofi, displazi varlığı) retrospektif taranarak değerlendirildi.
Bulgular: Çalışmaya median yaşı 53 (18-93) yıl olan 1344 (%53,1) kadın ve 1186 (%46,9) erkek toplam 2530 olgu dahil edildi. Olguların %27,8’inde HP ve %26,8’inde de İM tespit edildi. İM pozitif olan 677 hastaların median yaşı 59 (19-92)yıl idi ve %29,7’si (n=352) erkekti. IM pozitif ve negatif gruplar içinde cinsiyetler arasında median yaş açısından anlamlı farklılık saptanmazken (Sırasıyla p=0,584, p=0,642), IM pozitif saptanan hastalarda median yaş ve erkek cinsiyet oranı IM negatif olanlara nazaran daha yüksekti (Sırasıyla p<0,001, p=0,002). Erkek hastalar arasında HP pozitiflik oranı %31 (n=368) iken aynı oran kadın hastalar arasında %24,9 (n=334) (p=0,001) idi. HP pozitif hastalarda erkek cinsiyet belirgin olarak daha yüksek idi (%52,4’e karşılık %47,6) HP pozitif olanlarda median yaş anlamlı olarak daha düşük idi p<0,001). IM pozitif ve negatif saptanan hasta grupları arasında HP pozitifliği açısından anlamlı farklılık saptanmadı (p=0,341).
Sonuç: IM ileri yaşlarda ve erkek hastalarda daha fazla bulundu. HP pozitifliği erkek ve genç hastalarda daha fazla bulundu. IM ve HP sıklığı açısından anlamlı farklılık saptanmadı.

Keywords

intestinal metaplazi, helikobakter pilori, gastrik atrofi

Determination of the Frequency of Gastric Intestinal Metaplasia and Its Association with Helicobacter Pylori

Abstract

Aim: Gastric intestinal metaplasia (IM) is a precancerous lesion in the pathway to gastric cancer. Helicobacter pylori (HP) is a bacterium that has been associated with an increase in the development of non-cardia gastric cancer and is involved in the development of gastric IM and atrophic gastritis. In this study, we aimed to determine the frequency of IM and its relationship with HP in patients undergoing endoscopic examination with the indication of dyspepsia.
Material and Method: The study included 2530 patients who underwent upper gastrointestinal system endoscopy and had gastric biopsy at the Karadeniz Technical University Farabi Hospital Gastroenterology Clinic due to dyspepsia between January 2019 and January 2020. Demographic characteristics of the patients such as age and gender, biopsy findings (presence of IM, HP, atrophy, dysplasia) were evaluated retrospectively.
Results: A total of 2530 cases, 1344 (53.1%) women and 1186 (46.9%) men, with a median age of 53 (18-93) years were included in the study. HP was detected in 27.8% of the cases and IM was detected in 26.8%. The median age of 677 patients with positive IM was 59 (19-92) years, and 29.7% (n=352) were male. While no significant difference was found between the sexes in terms of median age within the IM positive and negative groups (p=0.584, p=0.642, respectively), the median age and male sex ratio were higher in patients with IM positive than those with IM negative (p<0.001, p=0.002, respectively). While the rate of HP positivity among male patients was 31% (n=368), the same rate was 24.9% (n=334) among female patients (p=0.001). The male gender was significantly higher in HP positive patients (52.4% vs. 47.6%), and the median age was significantly lower in HP positive patients (p<0.001). There was no significant difference in HP positivity between IM positive and negative patient groups (p=0.341).
Conclusion: IM was more common in older and male patients. HP positivity was found more frequently in male and young patients. No significant difference was found in the frequency of IM and HP.

Keywords

intestinal metaplasia, helicobacter pylori, gastric atrophy

References

• Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
• Correa P. Gastric Cancer. Gastroenterology Clinics of North America [Internet]. 2013 Jun;42(2):211–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0889855313000204
• Ishaq S, Nunn L. Helicobacter pylori and gastric cancer: a state of the art review. Gastroenterol Hepatol Bed Bench [Internet]. 2015;8(Suppl 1):S6–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26171139
• Eslick GD, Lim LL, Byles JE, Xia HH, Talley NJ. Association of Helicobacter pylori infection with gastric carcinoma: a meta-analysis. Am J Gastroenterol [Internet]. 1999 Sep;94(9):2373–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10483994
• Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev [Internet]. 2000;22(2):283–97. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11218379
• Malfertheiner P, Megraud F, O’Morain CA, Atherton J, Axon ATR, Bazzoli F, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut [Internet]. 2012 May;61(5):646–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22491499
• Tan MC, Balakrishnan M, Graham DY. Gastric cancer worldwide except Japan. Akiko Shiotani. Springer; 2018. 17–28 p.
• Rugge M, Fassan M, Graham DY. Epidemiology of gastric cancer. Strong VE, editor. Springer International Publishing; 2015. 23–34 p.
• Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin [Internet]. 2015 Mar;65(2):87–108. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25651787
• Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the gastric antrum. Gut [Internet]. 1992 Jan 1;33(1):16–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1740271
• Kosekli MA. Prevalence of Helicobacter pylori, gastric atrophy and intestinal metaplasia in gastric biopsy specimens: A retrospective evaluation of 1605 patients. Experimental Biomedical Research [Internet]. 2021 Oct 1;4(4):270–5. Available from: https://experimentalbiomedicalresearch.com/ojs/index.php/ebr/article/view/234/115
• Tosun İ, Çakır T. Şanlıurfa Siverek bölgesindeki helicobacter pylori pozitifliği oranı ve intestinal metaplazi ile arasındaki ilişki. Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2013;53(1).
• Ozdil K, Sahin A, Kahraman R, Yuzbasioglu B, Demirdag H, Calhan T, et al. Current prevalence of intestinal metaplasia and Helicobacter pylori infection in dyspeptic adult patients from Turkey. Hepatogastroenterology [Internet]. 57(104):1563–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21443121
• KORKMAZ H, KERPIC O, TEMEL T. Konya Bölgesinde Gastroskopi Yapılan Hastalarda Histopatolojik Bulgular ve Helicobacter Pylori Sıklığı. OSMANGAZİ JOURNAL OF MEDICINE [Internet]. 2015 Jun 20 [cited 2022 Jul 31];36(1):44–9. Available from: http://dergipark.gov.tr/doi/10.20515/otd.97021
• KESICI U, ÖZTÜRK G, KESİCİ S, YILMAZ A. Comparison of intestinal metaplasia and Helicobacter pylori positivity in patients from different age groups with antral gastritis. Journal of Surgery and Medicine [Internet]. 2021 Mar 1;5(3):226–9. Available from: https://ojs.selsistem.com.tr/doi/10.28982/josam.747328
• Bor S, Kitapcioglu G, Kasap E. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori. World Journal of Gastroenterology [Internet]. 2017;23(3):525. Available from: http://www.wjgnet.com/1007-9327/full/v23/i3/525.htm
• Erkut M, Uzun DY, Kaklıkkaya N, Fidan S, Yoğun Y, Coşar AM, et al. Sociodemographic characteristics and clinical risk factors of Helicobacter pylori infection and antibiotic resistance in the Eastern Black Sea region of Turkey. Turk J Gastroenterol [Internet]. 2020;31(3):221–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32343234
• Topal D, Göral V, Yılmaz F. Helicobacter pylori’nin intestinal metaplazı, gastrik atrofi bcl-2 ile ilişkisi. Türkiye Klinikleri Gastroenterohepatoloji Dergisi. 2004;15(2):65–73.
• Aydın HO, Kartal A, Oduncu M. Co-Occurrence of Helicobacter Pylori and Intestinal Metaplasia in Patients with Dyspepsia. Annals of Clinical and Analytical Medicine [Internet]. 2017;08(03). Available from: https://1drv.ms/b/s!AuzTlzd3oH6mnzbLLL-qTknAawJ4?e=13j4c9