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estudio fue determinar la asociación de los pólipos gástricos con los cambios histológicos de la mucosa circundante.
MATERIAL Y MÉTODOS: Estudio prospectivo, descriptivo y de corte transversal. De 6603 pacientes
examinados con endoscopia alta en el Hospital Nacional Edgardo Rebagliati Martins (Lima-Perú),
durante el período de enero del 2002 a
mayo del 2003, se detectaron 115 pólipos gástricos (1.74%),
incluyéndose 68 en el estudio. Los pólipos gástricos fueron evaluados
endoscópicamente, luego se extirparon y se tomaron biopsias de la
mucosa circundante. El estudio histológico determinó el tipo de pólipo
gástrico; y la presencia de inflamación, actividad (infiltración con
polimorfonucleares), atrofia, metaplasia y Helicobacter pylori en la
mucosa circundante.
RESULTADOS: La frecuencia de pólipos gástricos fue: hiperplásicos
51 (75%), adenomatosos 11 (16.2%), de glándulas fúndicas 4 (5.9%) e
inflamatorios 2 (2.9%). La mucosa circundante a los pólipos hiperplásicos
se caracterizó por la presencia estadísticamente significativa de
inflamación (100%, p=0.0001) y actividad (84.3%, p=0.001); mientras que
la mucosa circundante a los pólipos adenomatosos tuvo presencia estadísticamente
significativa de inflamación (100%, p=0.0001), actividad (81.8%,
p=0.001), atrofia (72.7%, p=0.017) y metaplasia (72.7%, p=0.017). El
grado de severidad de atrofia y metaplasia fue significativamente mayor
en la mucosa circundante de los pólipos adenomatosos que de los hiperplásicos
(p=0.019 y p=0.001).
CONCLUSIONES: Los pólipos hiperplásicos se asocian con presencia
de inflamación y actividad en la mucosa circundante; mientras que los pólipos
adenomatosos se asocian con presencia de inflamación, actividad,
atrofia y metaplasia en la mucosa circundante. La atrofia y metaplasia
fueron más severas en la mucosa circundante a los pólipos
adenomatosos.
PALABRAS CLAVE: Pólipo gástrico, gastritis,
atrofia, metaplasia
SUMMARY
PURPOSE:
Gastric polyps are elevated epithelial lesions which pathogenesis and
natural history are not well known. The purpose of this study was to
determine the association between gastric polyps and histological
changes of the surrounding mucosa.
MATERIAL AND METHODS: Prospective, descriptive and transversal
study. From 6603 patients examined through upper endoscopy at the
National Hospital Edgardo Rebagliati Marins (Lima-Peru) from January
2002 to May 2003,115 gastric polyps were detected (1.74%) 68 of which
were included in this study. Gastric polyps were examined through
endoscopy and thereafter excised, taking biopsies of the surrounding
mucosa. The histological examination established the gastric polyp type
and the presence of inflammation, activity (infiltration with
polymorphonuclears), atrophy, metaplasia, and Helicobacter pylori in the
surrounding mucosa.
RESULTS: Frequency of gastric polyps was as follows: hyperplastic:
51 (75%) adenomatous: 11 (16.2%) of fundic glands: 4 (5.9%) and
inflammatory: 2 (2.9%). The mucosa surrounding hyperplastic polyps was
characterized by the statistically significant presence of inflammation
(100%, p=0.0001) and activity (84.3%, p=0.001) while the mucosa
surrounding the adenomatous polyps showed statistically significant
presence of inflammation (100%, p=0.0001) activity (81.8%, p=0.001),
atrophy (72.7%, p=0.017) and metaplasia (72.7%, p=0.017). The severity
of atrophy and metaplasia was significantly higher in the mucosa
surrounding adenomatous polyps than in that surrounding hyperplastic
polyps (p=0.019 and p=0.001).
CONCLUSIONS: Hyperplastic polyps are associated with the presence
of inflammation and activity in the surrounding mucosa, whereas
adenomatous polyps are associated with the presence of inflammation,
activity, atrophy, and metaplasia in the surrounding mucosa. Atrophy and
metaplasia were more severe in the mucosa surrounding adenomatous
polyps.
KEY WORDS: Gastric polyp, gastritis, atrophy,
metaplasia
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