Erişkinlerde gastrik nodularite ve Helikobakter Pylori ile ilişkisi
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Tarih
2017
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info:eu-repo/semantics/openAccess
Özet
Giriú ve amaç: Gastrik nodularite özellikle pediatrik yaú gurubunda görüldü÷ü bildirilen endoskopik bir tanÕmlamadÕr. Birçok çalÕúma çocuklardaki noduler gastritin Helicobacter pylori enfeksiyonu ile güçlü iliúkisini ortaya koymakla birlikte, bu endoskopik paternin eriúkinlerdeki do÷al seyri ve önemi az anlaúÕlmÕúWÕr. ÇalÕúmamÕzda amaç, gastrik nodulariteli eriúkinlerin demografik özellikleri, nodularitenin Helikobakter pylori ve patojenik suúlarÕ ile olan iliúkisinin güncelleútirilmiú Sydney histopatolojik sÕQÕflama sisteminden yararlanÕlarak araúWÕUÕlmasÕ olmuútur. Materyal ve metod: Bu prospektif çalÕúmada, dispepsi gibi abdominal semptomlar için endoskopi yapÕlan eriúkin hastalar çalÕúmaya alÕndÕ. Gastrik nodularite saptananlar ‘’hasta’’, nodularitesi olmayan gastritli olgular ise ‘’kontrol’’ gurubunu oluúturdu. ÇalÕúmada 82 hasta, 86 kontrol bulundu. HastalarÕn yaú, cins, sigara veya alkol kullanÕm öyküsü, vücut kitle indeksleri, ilaç alÕm öyküsü kaydedildi. Tüm gastrik biyopsi örnekleri Sydney sÕQÕflamasÕ ile de÷erlendirildi. H.pylori pozitifli÷i histolojik yöntem ve hÕzlÕ üreaz testi ile de÷erlendirildi. Serum örneklerinde uygun ticari yöntemle Helicobacter pylori CagA ve VacA IgG antikorlarÕ çalÕúÕldÕ. Sonuçlar: Hasta gurubunda 59 kadÕn, 23 erkek, kontrol gurubunda ise 49 kadÕn ve 37 erkek vardÕ. KadÕn cinsiyet gastrik nodularite riskini yaklaúÕk 2 kat arttÕrmaktadÕr. Nodularitesi olanlarÕn %43.9’u, nodularitesi olmayanlarÕn ise %81.4’ü 24 yaúÕndan büyük idi. Yirmi dört yaúÕndan küçük olmak nodularite riskini 6 kata yakÕn arttÕrmaktaydÕ. ÇalÕúma gurubunda H.pylori pozitifli÷i %64.3 oranÕnda gözlendi. H.pylori pozitif olanlarÕn %58.3’ünde nodularite saptanÕrken, bu durum negatif olanlarÕn %31.7’sinde gözlendi. H.pylori pozitifli÷i nodularite riskini 3 kat arttÕrmÕúWÕr. CagA(+) suú taúÕyan H.pylori olgularÕQÕn %61.7’sinde nodularite saptanÕrken, %38.3’ünde nodularite izlenmedi. CagA(+)’li÷i nodularite riskini yaklaúÕk 3 kat arttÕrmÕúWÕr. VacA(+)’lerin ise %60.8’inde nodularite izlenirken, %39.2’sinde izlenmemiútir. VacA(+)’li÷inde risk artÕúÕ CagA(+) hastalara yakÕndÕ. Sonuç: Gastrik nodularite eriúkin hastalarda yaygÕndÕr. KadÕn cinsiyet bir risk faktörü olabilir. H.pylori pozitifli÷i ve özellikle patojenik suúlarÕ olan CagA ve VacA pozitifli÷i nodularite riskini önemli oranda arttÕrmaktadÕr. Sigara içimi nodularite için koruyucu olabilir. Gastrik nodulariteli eriúkinlerin uzun dönem yansÕmalarÕQÕn incelenece÷i prospektif çalÕúmalara gereksinim vardÕr.
Background and aim: Gastric nodularity is an endoscopic description which is especially seen in pediatric age group. Although many studies have found that nodular gastritis in children is strongly associated with Helicobacter pylori infection the natural course and the significance of this endoscopic pattern in adults is poorly understood. Our aim was to determine the demographic features of adults with gastric nodularity and to see the relationship with Helicobacter pylori and its pathogenic strains utilizing from updated Sydney classification system. Material and Methods: In this prospective study, adult patients who underwent endoscopy for abdominal symptoms such as dyspepsia were included in the study. ‘Patient’ group was constituted from persons with gastric nodularity, while ‘control’ group was constituted from persons without nodularity. There were 82 patients and 86 controls in the study. We recorded their age, gender, smokind and alcohol history, body mass index and drug history. All gastric biopsy specimens were evaluated by Sydney classification. Helicobacter pylori positivity was evaluated by hystological method and rapid urease test. Serum samples were studied for Helicobacter pylori IgG antibodies to CagA and VacA by means of a commercially available assay. Results: There were 59 female, 23 male persons in patient group and 49 female, 37 male persons in control group. Female gender increased the risk of gastric nodularity approximately by two-fold. 43.9 per cent of patients with nodularity and 81.4 per cent of controls were older than 24 years old. Being under 24 years old increased the risk of nodularity approximatelly by six-fold. H.pylori positivity was obseved in 64.3% of patients. Nodularity was seen in 58.3% of H.pylori positive patients, while 31.7% of H.pylori negative patients. H.pylori positivity increased the risk of nodularity by three-fold. 60.8 per cent of the patients with H.pylori CagA(+) strain had nodularity, while 38.3 per cent were not. Having the H.pylori CagA(+) strain increased the risk of nodularity approximatelly by threefold. 60.8 per cent of the patients with H.pylori VacA(+) strain had nodularity, while 39.2 per cent were not. Risk increase in patients with H.pylori VacA(+) strain was similar to patients with H.pylori CagA(+) ones. Conclusion: Gastric nodularity is prevelant amoung adult patients. Female gender may be a risk factor for nodularity. H.pylori positivity, especially its pathogenic strains CagA and VacA positivity, rises the nodularity risk significantly. Smoking may be a protective habit against nodularity. There is need for prospective studies evaluating the long term projections of gastric nodularity in adults.
Background and aim: Gastric nodularity is an endoscopic description which is especially seen in pediatric age group. Although many studies have found that nodular gastritis in children is strongly associated with Helicobacter pylori infection the natural course and the significance of this endoscopic pattern in adults is poorly understood. Our aim was to determine the demographic features of adults with gastric nodularity and to see the relationship with Helicobacter pylori and its pathogenic strains utilizing from updated Sydney classification system. Material and Methods: In this prospective study, adult patients who underwent endoscopy for abdominal symptoms such as dyspepsia were included in the study. ‘Patient’ group was constituted from persons with gastric nodularity, while ‘control’ group was constituted from persons without nodularity. There were 82 patients and 86 controls in the study. We recorded their age, gender, smokind and alcohol history, body mass index and drug history. All gastric biopsy specimens were evaluated by Sydney classification. Helicobacter pylori positivity was evaluated by hystological method and rapid urease test. Serum samples were studied for Helicobacter pylori IgG antibodies to CagA and VacA by means of a commercially available assay. Results: There were 59 female, 23 male persons in patient group and 49 female, 37 male persons in control group. Female gender increased the risk of gastric nodularity approximately by two-fold. 43.9 per cent of patients with nodularity and 81.4 per cent of controls were older than 24 years old. Being under 24 years old increased the risk of nodularity approximatelly by six-fold. H.pylori positivity was obseved in 64.3% of patients. Nodularity was seen in 58.3% of H.pylori positive patients, while 31.7% of H.pylori negative patients. H.pylori positivity increased the risk of nodularity by three-fold. 60.8 per cent of the patients with H.pylori CagA(+) strain had nodularity, while 38.3 per cent were not. Having the H.pylori CagA(+) strain increased the risk of nodularity approximatelly by threefold. 60.8 per cent of the patients with H.pylori VacA(+) strain had nodularity, while 39.2 per cent were not. Risk increase in patients with H.pylori VacA(+) strain was similar to patients with H.pylori CagA(+) ones. Conclusion: Gastric nodularity is prevelant amoung adult patients. Female gender may be a risk factor for nodularity. H.pylori positivity, especially its pathogenic strains CagA and VacA positivity, rises the nodularity risk significantly. Smoking may be a protective habit against nodularity. There is need for prospective studies evaluating the long term projections of gastric nodularity in adults.
Açıklama
Gastroenteroloji Yan Dal Uzmanlık tezi olarak hazırlanmıştır.
Anahtar Kelimeler
Gastrik nodularite, Helikobakter pylori, Gastroenteroloji, Gastroenterology, Gastric nodularity, Helicobacter pylori, Erişkinler
